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ROP APPLICATION
Directions: Please Print Legibly
Name: __________________________________________
Jarquin Erick ____________________
5-14-19
(Last) (First) (Middle) Date
Have you ever been convicted, pleaded guilty or no contest to a misdemeanor or felony?
No Yes If yes, explain:________________________________
RECORD OF EDUCATION
Course of
study or Last year Did you Diploma
Name of School City/State major completed graduate? or degree
High School Merced High School 209 1 2 3 4 yes diploma
College/ 1 2 3 4
University
Other
1 2 3 4
(Specify)
List appropriate extracurricular activities, clubs, organizations and courses for this position:
I was in football for 4 years at MHS.
FULL TIME
AVAILABILITY PART TIME
Period of Employment Job Title and Duties Performed Company Name, Address, and Phone Number
From: To:
Manger
Title__________________________Last 17$
Salary: _____________
Los Reyes
_________________________________________________
2018
______ 2019
______
Mo / Yr Mo/Yr
Duties
Merced CA
_________________________________________________
1
Total ____Yrs. 2
________Mo.
Stock,Money,Checks,Emplyos 2092092099
_________________________________________________
40+
Hours Per Week:_________
Reason For Leaving: _________________________________________________
Trying something new
Supervisor’s Name: _________________________________________________
_____________________________________________________
From: To:
Title__________________________Last Salary: _____________ _________________________________________________
______ ______
Mo/ Yr Mo/Yr Duties: _________________________________________________
Total ____Yrs. ________Mo. _________________________________________________
Hours Per Week:_________
Reason For Leaving: _________________________________________________
_________________________________________________
Supervisor’s Name:
________________________________________________
From: To:
Title___________________________Last Salary: ____________ _________________________________________________
______ ______
Mo /Yr Mo/Yr Duties: _________________________________________________
Total ____Yrs. ________Mo. _________________________________________________
Hours Per Week:_________
Reason For Leaving: _________________________________________________
_________________________________________________
Supervisor’s Name:
________________________________________________
Date:_________________________Signature:_________________________________________________________________
N:\ROP\Charlotte Klock\ROP Forms\Forms\ROP Job Application with availbility back-for fillable.rtf Revised 7/10