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Job Application Pader X
Job Application Pader X
Job Application Pader X
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ROP APPLICATION
Directions: Please Print Legibly
Pader
N/A
Name: Xiong
__________________________________________
(Last)
(First)
May 5, 2014
____________________
(Middle)
Date
(City)
(209 ) 383-3917
(Telephone Number)
(State)
(Zip Code)
pxiong101463@muhsdstudents.org
230-2206
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)
Vet
Position applied for:_______________________________________________________________
Hmong
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
_______________________
(Number)
RECORD OF EDUCATION
Name of School
City/State
Course of
study or
major
High School
Last year
completed
Did you
graduate?
Diploma
or degree
yes
Diploma
1 2 3 4
Merced, CA
College/
University
General
1 2 3 4
Other
(Specify)
1 2 3 4
List appropriate extracurricular activities, clubs, organizations and courses for this position:
N/A
FULL TIME
AVAILABILITY
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
PART TIME
THURSDAY
FRIDAY
SATURDAY
NA
NA
Title__________________________Last
Salary: _____________
NA
_________________________________________________
Duties
_________________________________________________
NA
_________________________________________________
To:
NA
______
NA
______
Mo / Yr
Mo/Yr
NA
Total NA
____Yrs. ________Mo.
NA
Hours Per Week:_________
Reason For Leaving:
_________________________________________________
NA
Supervisors Name:
NA
_____________________________________________________
From:
To:
NA
______
NA
______
Mo/ Yr
Mo/Yr
NA
NA
Total ____Yrs.
________Mo.
_________________________________________________
NA
Title__________________________Last
Salary: _____________
NA
NA
_________________________________________________
Duties:
_________________________________________________
NA
_________________________________________________
NA
Hours Per Week:_________
Reason For Leaving:
_________________________________________________
NA
_________________________________________________
Supervisors Name:
NA
________________________________________________
From:
To:
NA
______
NA
______
Mo /Yr
Mo/Yr
NA
NA
Total ____Yrs.
________Mo.
NA
NA
Title___________________________Last
Salary: ____________
NA
_________________________________________________
Duties:
_________________________________________________
NA
_________________________________________________
NA
Hours Per Week:_________
Reason For Leaving:
_________________________________________________
NA
Supervisors Name:
NA
________________________________________________
_________________________________________________
Phone
Occupation_______
Paoze Lee
Merced, CA 95348
(209) 385-6465
Teacher
________________________________________________________________________________________________________________________________
2.
(209) 385-6465
Cathy White
Teacher
Merced, CA 95348
________________________________________________________________________________________________________________________________
3.
Kassie Mua
(209) 385-6465
Merced, CA 95348
Teacher
________________________________________________________________________________________________________________________________
Date:_________________________Signature:_________________________________________________________________
Revised 7/10