ROP APPLICATION

Directions: Please Print Legibly

Mora
Zoee
Deziree
Name: __________________________________________

(Last)

(First)

4/28/15
____________________

(Middle)

Date

3563 Santiago Avenue

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

CA
Merced
95348
_______________________________________________________________________________

(City)

(209 ) 658-4815
(Telephone Number)

(State)

(Zip Code)

zoee.mora@yahoo.com
617-3550
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)

Position applied for:_______________________________________________________________

Service Clerk
Skills and/or competencies which qualify you for this position:
-Hard Working
-Punctual
-Excellent customer service
none
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

General
Education

Last year
completed

Did you
graduate?

Diploma
or degree

1 2 3 4

Yes

Diploma

1 2 3 4

Other
(Specify)

1 2 3 4

List appropriate extracurricular activities, clubs, organizations and courses for this position:
Freshman, JV, Varsity Softball and Basketball

FULL TIME

AVAILABILITY

PART TIME

SUNDAY

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

anytime

3-anytime

3-anytime

3-anytime

3-anytime

3-anytime

anytime

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

Period of Employment
From:

Job Title and Duties Performed

Company Name, Address, and Phone Number

9.25
Service Clerk
Title__________________________Last
Salary: _____________

_________________________________________________

Duties

_________________________________________________

-Push Carts
-Assist customer needs

_________________________________________________

To:

2014
______

present
______

Mo / Yr

Mo/Yr

11
Total ____Yrs. ________Mo.
25
Hours Per Week:_________
Reason For Leaving:
I still work at Foodmaxx
just looking for another job.

From:

Foodmaxx

1300 W Olive Ave, CA 95348

209-722-3385

_________________________________________________
Supervisors Name:
Sal
_____________________________________________________

_________________________________________________

Title__________________________Last Salary: _____________

_________________________________________________

Duties:

_________________________________________________

To:

______

______

Mo/ Yr

Mo/Yr

Total ____Yrs. ________Mo.

_________________________________________________

Hours Per Week:_________

Reason For Leaving:

_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________

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.

Complete Address (Include City, State, Zip)

Phone

Occupation_______

Carlos Morales
Construction Worker

________________________________________________________________________________________________________________________________
2. Danielle

Verderber
Makes Deli Sandwhic

________________________________________________________________________________________________________________________________
3. Stephanie

Barba
Retail

________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.

I understand that misrepresentation or omission of facts is cause for dismissal.

Date:_________________________Signature:_________________________________________________________________