ROP APPLICATION

Directions: Please Print Legibly

Marana
Alexa
Rae
Name: __________________________________________

(Last)

(First)

5/6/2013
____________________

(Middle)

Date

2091 Lopes Avenue

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

CA
Merced
95341
_______________________________________________________________________________

(City)

(209 ) 631-7940
(Telephone Number)

(State)

(Zip Code)

alexamarana@yahoo.com
383-3600
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)

Position applied for:_______________________________________________________________

Boarding Assistant
Skills and/or competencies which qualify you for this position:
Fast learner, Follows directions, does thorough work for cleaning for example

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

Last year
completed

Did you
graduate?

Basic

1 2 3 4

ending
June 2014

Merced, CA

College/
University

Diploma
or degree

1 2 3 4

Other
(Specify)

1 2 3 4

List appropriate extracurricular activities, clubs, organizations and courses for this position:

FULL TIME

AVAILABILITY
SUNDAY

PART TIME

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

3-8pm

3-8pm

3-8pm

3-8pm

3-8pm

SATURDAY

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

Period of Employment
From:

Job Title and Duties Performed

Company Name, Address, and Phone Number

20 bucks
house maid
Title__________________________Last
Salary: _____________

_________________________________________________

Duties

_________________________________________________

cleans kitchen, bathroon and livingrooms

_________________________________________________

To:

2010
______

present
______

Mo / Yr

Mo/Yr

5
4
Total ____Yrs.
________Mo.

10
Hours Per Week:_________
Reason For Leaving:

From:

_________________________________________________
Supervisors Name:
Lillian Marana
_____________________________________________________

_________________________________________________

around $300
Title__________________________Last
Salary: _____________
carpeners assistant

_________________________________________________

Duties:

_________________________________________________

replaces linolium floors, painted fences and cleaned

apartments

_________________________________________________

To:

june 2012
______

aug 2012
______

Mo/ Yr

Mo/Yr

3
0
Total ____Yrs.
________Mo.
Hours Per Week:_________
20
Reason For Leaving:

lillians place 2091 lopes avenue (209)658-8647

(209)388-1461

_________________________________________________

only a summer job

_________________________________________________
Supervisors Name:
Jeff Koehn
________________________________________________

From:

To:

______

______

Mo /Yr

Mo/Yr

Title___________________________Last Salary: ____________

_________________________________________________

Duties:

_________________________________________________

Total ____Yrs. ________Mo.

_________________________________________________

Hours Per Week:_________

Reason For Leaving:

_________________________________________________

Supervisors Name:
________________________________________________

_________________________________________________

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

Name
1.

Rebecca Pascal

Complete Address (Include City, State, Zip)

205 W. Olive Avenue 95344

Phone

Occupation_______

(209)385-6465

________________________________________________________________________________________________________________________________
2. Tony

Calip

Merced, CA

(209)819-0147

________________________________________________________________________________________________________________________________
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:_________________________________________________________________

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

Revised 7/10