ROP APPLICATION

Directions: Please Print Legibly

Name: __________________________________________
Tovar Paulino De Jesus ____________________
04/24/2017
(Last) (First) (Middle) Date

Present mailing address:___________________________________________________________

635 East Olive Avenue
(P.O. Box or Street Number)

Merced California 95340

_______________________________________________________________________________
(City) (State) (Zip Code)

(209 ) 640-9027 ( )____________________ ____________________________

[email protected]
(Telephone Number) (Alternative Telephone Number) (Email Address)

Position applied for:_______________________________________________________________

Waiter

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

-Bilingual
-Disciplined
-Grew up in restaurant environment

Languages spoken and/or written (other than English):___________________________________

Spanish

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 Drivers License?

No Yes _______________________
Y2590524
(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 School Merced, CA 1 2 3 4 Still
Attending
College/ 1 2 3 4
University

Other
1 2 3 4
(Specify)

List appropriate extracurricular activities, clubs, organizations and courses for this position:
-Merced High School Football- 9th through 12th grade
-Gateway Scholars Program- 11th through 12th grade

FULL TIME
AVAILABILITY PART TIME

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

8 AM-11 PM 3 PM-8 PM 3 PM-8 PM 3 PM-8 PM 3 PM- 8PM 3 PM- 11 PM 8 AM-11 PM

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:
Title__________________________Last Salary: _____________ _________________________________________________
______ ______
Mo / Yr Mo/Yr
Duties _________________________________________________
Total ____Yrs. ________Mo.
_________________________________________________
Hours Per Week:_________
Reason For Leaving: _________________________________________________

Supervisors Name: _________________________________________________

_____________________________________________________

From: To:
Title__________________________Last Salary: _____________ _________________________________________________
______ ______
Mo/ Yr Mo/Yr Duties: _________________________________________________
Total ____Yrs. ________Mo. _________________________________________________
Hours Per Week:_________
Reason For Leaving: _________________________________________________

_________________________________________________
Supervisors Name:
________________________________________________

From: To:
Title___________________________Last Salary: ____________ _________________________________________________
______ ______
Mo /Yr Mo/Yr Duties: _________________________________________________
Total ____Yrs. ________Mo. _________________________________________________
Hours Per Week:_________
Reason For Leaving: _________________________________________________

_________________________________________________
Supervisors Name:
________________________________________________

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

Name Complete Address (Include City, State, Zip) Phone Occupation_______
1.
Rob Scheidt 205 W Olive Ave, Merced, CA (209) 658-9517
Teacher & Coach
________________________________________________________________________________________________________________________________

2. Patricia Zarco 205 W Olive Ave, Merced, CA (559) 241-7476

Academic Advisor
________________________________________________________________________________________________________________________________

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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