Rop Job Application

ROP APPLICATION
Directions: Please Print Legibly

Ford
Sarah
Ashley
Name: __________________________________________
(Last)
(First)
May 8, 2015
____________________
(Middle)
Date
1615 Primrose Ave

Present mailing address:___________________________________________________________
(P.O. Box or Street Number)

CA
Merced
95340
_______________________________________________________________________________
(City)
(209 ) 777-0712
(Telephone Number)
(State)
(Zip Code)
sarahford30@yahoo.com
383-3193
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)
Position applied for:_______________________________________________________________

Dairy cow feeder
Skills and/or competencies which qualify you for this position:
Worked with livestock for the past five years. Had to feed animal twice a day and clean pen and keep
animal clean.
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 Drivers License?

No
Yes
_______________________
(Number)
RECORD OF EDUCATION
Name of School
High School
City/State
Merced High School
Course of
study or
major
Merced, CA
College/
University
Last year
completed
Did you
graduate?
1 2 3 4
Currently
attending
Diploma
or degree
1 2 3 4
Other
(Specify)
1 2 3 4
List appropriate extracurricular activities, clubs, organizations and courses for this position:
Been a part of Merced FFA for the past four years.
FULL TIME
AVAILABILITY
PART TIME
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
7am-7pm
4pm-11pm
4pm-11pm
4pm-11pm
4pm-11pm
4pm-11pm
7am-7pm
RECORD OF EMPLOYMENT: (Begin with your most recent job)

Period of Employment
From:
Job Title and Duties Performed
Company Name, Address, and Phone Number
Title__________________________Last Salary: _____________
_________________________________________________
Duties
_________________________________________________
To:
______
______
Mo / Yr
Mo/Yr
Total ____Yrs. ________Mo.
_________________________________________________
Hours Per Week:_________
Reason For Leaving:
From:
_________________________________________________
Supervisors Name:
_____________________________________________________
_________________________________________________
Title__________________________Last Salary: _____________
_________________________________________________
Duties:
_________________________________________________
To:
______
______
Mo/ Yr
Mo/Yr
Total ____Yrs. ________Mo.
_________________________________________________

Reason For Leaving:
_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________
From:
To:
______
______
Mo /Yr
Mo/Yr
Title___________________________Last Salary: ____________
_________________________________________________
Duties:
_________________________________________________
Total ____Yrs. ________Mo.
_________________________________________________

Reason For Leaving:
_________________________________________________
Supervisors Name:
________________________________________________
_________________________________________________
REFERENCES: Give the names of three persons not related to you.

Name
1.
Lisa Melgosa
Complete Address (Include City, State, Zip)
Merced, CA
Phone
Occupation_______
(209) 756-0456
________________________________________________________________________________________________________________________________
2. Nick
Francis
Atwater, CA
(209) 205-8395
________________________________________________________________________________________________________________________________
3. Steve
Mua
Merced, CA
(209) 631-4769
________________________________________________________________________________________________________________________________
I authorize investigation of all statements contained in this application.

I understand that misrepresentation or omission of facts is cause for dismissal.
Date:_________________________Signature:_________________________________________________________________
N:\ROP\Charlotte Klock\ROP Forms\Forms\ROP Job Application with availbility back-for fillable.rtf
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ROP APPLICATION

Directions: Please Print Legibly

1615 Primrose Ave

(P.O. Box or Street Number)

Position applied for:_______________________________________________________________

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

Do you possess a valid California Drivers License?

Merced High School

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

Job Title and Duties Performed

Company Name, Address, and Phone Number

Title__________________________Last Salary: _____________

Total ____Yrs. ________Mo.

Title__________________________Last Salary: _____________

Total ____Yrs. ________Mo.

Hours Per Week:_________

Title___________________________Last Salary: ____________

Total ____Yrs. ________Mo.

Hours Per Week:_________

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

Complete Address (Include City, State, Zip)

I authorize investigation of all statements contained in this application.

N:\ROP\Charlotte Klock\ROP Forms\Forms\ROP Job Application with availbility back-for fillable.rtf

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