Rop Application: Directions: Please Print Legibly
Rop Application: Directions: Please Print Legibly
(Last)
(First)
03/28/16
____________________
(Middle)
Date
1217 Aups Ct
Present mailing address:___________________________________________________________
(City)
(209 ) 7619527
(Telephone Number)
(State)
(Zip Code)
[email protected]
7228447
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)
Punjabi
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:________________________________
Yes
_______________________
F810593
(Number)
RECORD OF EDUCATION
Name of School
High School
City/State
Course of
study or
major
Merced, CA
College/
University
Last year
completed
Did you
graduate?
1 2 3 4
Not Yet
Diploma
or degree
1 2 3 4
Other
(Specify)
1 2 3 4
List appropriate extracurricular activities, clubs, organizations and courses for this position:
FBLA a bussiness club, CSF a schloatship federation which awards for academic excellence
FULL TIME
AVAILABILITY
PART TIME
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
All Day
After 4pm
After 4pm
After 4pm
After 4pm
After 4pm
All Day
_________________________________________________
Duties
_________________________________________________
To:
______
______
Mo / Yr
Mo/Yr
_________________________________________________
Hours Per Week:_________
Reason For Leaving:
From:
_________________________________________________
Supervisors Name:
_____________________________________________________
_________________________________________________
_________________________________________________
Duties:
_________________________________________________
To:
______
______
Mo/ Yr
Mo/Yr
_________________________________________________
_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________
From:
To:
______
______
Mo /Yr
Mo/Yr
_________________________________________________
Duties:
_________________________________________________
_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________
_________________________________________________
Kevin Chang
Merced CA 95348
Phone
Occupation_______
209-743-3748
Cashier/Delivery
________________________________________________________________________________________________________________________________
2.
________________________________________________________________________________________________________________________________
3.
________________________________________________________________________________________________________________________________
Date:_________________________Signature:_________________________________________________________________