ROP APPLICATION

Directions: Please Print Legibly

Xiong Kiri Ci Iab

Name: __________________________________________ 05/15/2019
____________________
(Last) (First) (Middle) Date

Present mailing address:___________________________________________________________

2835 Park Avenue, Apt 3
(P.O. Box or Street Number)

Merced California 95348

_______________________________________________________________________________
(City) (State) (Zip Code)

( 209 ) 205-8145 ( 209 )____________________

489-7452 xiong.kiri@yahoo.com
____________________________
(Telephone Number) (Alternative Telephone Number) (Email Address)

Position applied for:_______________________________________________________________

Paralegal

Skills and/or competencies which qualify you for this position:

Though there is always room for improvement, I believe my skills with English and communication are
highly applicable to this position. I have much experience, from my college career, within the law and
political field such as mock trials, group collaborations, etc., which would prepare me for my future career.

Hmong
Languages spoken and/or written (other than English):___________________________________
Have you ever been convicted, pleaded guilty or no contest to a misdemeanor or felony?
No Yes If yes, explain:________________________________

Do you possess a valid California Driver’s License?

No Yes _______________________
y4175767
(Number)

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 Merced, NA 1 2 3 4 Currently
California attending

College/ 1 2 3 4
University

Other
1 2 3 4
(Specify)

List appropriate extracurricular activities, clubs, organizations and courses for this position:
I held positions, secretary and president, for a community service club during my junior and senior year of high
school.

FULL TIME
AVAILABILITY PART TIME

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

4pm-8pm 4pm-8pm 4pm-8pm 4pm-8pm 4pm-7pm 12pm-12am

RECORD OF EMPLOYMENT: (Begin with your most recent job)

Period of Employment Job Title and Duties Performed Company Name, Address, and Phone Number
From: To:
Cashier
Title__________________________Last 05/10/2019
Salary: _____________
205 W Olive Avenue; Merced, California 95348
_________________________________________________
08/2015
______ 11/2018
______
Mo / Yr Mo/Yr
Duties _________________________________________________
3 37
Total ____Yrs. ________Mo. During work, I would handle food products for
_________________________________________________
1.5 hours
Hours Per Week:_________ customers and occasionally handle money
Reason For Leaving:
transactions. _________________________________________________
Family reasons.
Supervisor’s Name: _________________________________________________
Sylvia Garcia
_____________________________________________________

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:
________________________________________________

REFERENCES: Give the names of three persons not related to you.

Name Complete Address (Include City, State, Zip) Phone Occupation_______
1.

________________________________________________________________________________________________________________________________

2.

________________________________________________________________________________________________________________________________

3.

________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.

I understand that misrepresentation or omission of facts is cause for dismissal.

Date:_________________________Signature:_________________________________________________________________

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