Rop Application: Directions: Please Print Legibly
Rop Application: Directions: Please Print Legibly
Rop Application: Directions: Please Print Legibly
(Last)
(First)
05/08/2014
____________________
(Middle)
Date
180 McGregor St
Present mailing address:___________________________________________________________
(City)
(209 ) 720-9467
(Telephone Number)
(State)
(Zip Code)
jazminromero421@gmail.com
388-1077
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)
Yes
If yes, explain:________________________________
Yes
_______________________
(Number)
RECORD OF EDUCATION
Name of School
High School
City/State
Merced,CA
Course of
study or
major
Last year
completed
Did you
graduate?
Diploma
or degree
Mathmatics
1 2 3 4
Yes
Diploma
College/
University
1 2 3 4
Other
(Specify)
1 2 3 4
List appropriate extracurricular activities, clubs, organizations and courses for this position:
Four years involved in FFA
FULL TIME
AVAILABILITY
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
PART TIME
THURSDAY
FRIDAY
SATURDAY
_________________________________________________
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:
________________________________________________
_________________________________________________
Phone
Occupation_______
209 987-6543
Truck Driver
________________________________________________________________________________________________________________________________
2. Teresa
Cervantes
209 123-4567
Raileys Bakery
________________________________________________________________________________________________________________________________
3. Patricia
Prado
209 456-1234
Physical Therapist
________________________________________________________________________________________________________________________________
Date:_________________________Signature:_________________________________________________________________