Reset Form

Print Form

ROP APPLICATION
Directions: Please Print Legibly
Stephanie
L
Name: Flores
__________________________________________

(Last)

(First)

05-10-15
____________________

(Middle)

Date

1070 Wst 2nd St

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

California
Merced
95341
_______________________________________________________________________________

(City)

(State)

(209 ) 230-0884

(Zip Code)

Flores.Stephanie83@yahoo.com
N/A
(
)____________________
____________________________
(Alternative Telephone Number)
(Email Address)

(Telephone Number)

Cashier/Sales Rep
Position applied for:_______________________________________________________________

Skills and/or competencies which qualify you for this position:

ability to multi task, Perform task in a timely manner

Spanish
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

Course of
study or
major

City/State

High School

Merced High School

College/
University
Other
(Specify)

Merced CA

Last year
completed

Did you
graduate?

Diploma
or degree

1 2 3 4

Pending
2015

Pending
2015

General Ed
1 2 3 4

N/A
1 2 3 4

N/A

List appropriate extracurricular activities, clubs, organizations and courses for this position:
ROP Marketing , boys and girls club

FULL TIME

AVAILABILITY

PART TIME

SUNDAY

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

Open-Noon

4pm-10pm

4om-10pm

------

4pm-10pm

------

------

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

Period of Employment
From:

Job Title and Duties Performed

Company Name, Address, and Phone Number

Prep Cook
ROP
Title__________________________Last
Salary: _____________

Bear
Creek Shopping Center
_________________________________________________

Duties

2806
G Street
_________________________________________________

To:

9/14
______

Preseny
______

Mo / Yr

Mo/Yr

9
Total ____Yrs. ________Mo.
8
Hours Per Week:_________
Reason For Leaving:

Prep Cook, Wash dishes,Prepare food such as

potatoes and croutons

Merced
CA 95340
_________________________________________________

Supervisors Name:
Melissa Rasmussen
_____________________________________________________

_________________________________________________

Title__________________________Last
Salary: _____________
N/A

_________________________________________________

Duties:

_________________________________________________

(209)723-0238
_________________________________________________

Still there

From:

To:

______

______

Mo/ Yr

Mo/Yr

Total ____Yrs. ________Mo.

_________________________________________________

Hours Per Week:_________

Reason For Leaving:

_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________

From:

To:

______

______

Mo /Yr

Mo/Yr

N/A
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_______

Merced High School

Lisa Escobedo

205 West Olive Merced CA 95341

(209)617-4628

ROP Teacher

________________________________________________________________________________________________________________________________

Merced High School

2.

(209)777-2496

Andrea DeLeon

E.L.D Teacher

205 West Olive Merced CA 95341

________________________________________________________________________________________________________________________________

Boys and Girls Club

3.

April Morin

(209)722-9922

615 W 15th St Merced CA 95340

Volunteer Cordinator

________________________________________________________________________________________________________________________________

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