ROP APPLICATION

Directions: Please Print Legibly

Brown
Zezhua
Darrick
Name: __________________________________________

(Last)

(First)

4/15/2015
____________________

(Middle)

Date

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)
California
Merced
95348
_______________________________________________________________________________

(City)

(State)

(209 ) 500-8660

(Telephone Number)

(Zip Code)

zeebrown@live.com
)____________________ ____________________________

(Alternative Telephone Number)

(Email Address)

Position applied for:_______________________________________________________________

Rough Neck- Oil Rig Hand
Skills and/or competencies which qualify you for this position:
Skilled Welder, Quick Learner, Experienced Heavy Machinery Operator

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

Merced High

City/State

Course of
study or
major

Merced California

College/
University

Last year
completed

Did you
graduate?

Diploma
or degree

1 2 3 4

Yes

Yes

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

MONDAY

TUESDAY

WEDNESDAY

PART TIME

THURSDAY

FRIDAY

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

7 per hour
Farm Hand
Title__________________________Last
Salary: _____________

_________________________________________________

Duties

_________________________________________________

To:

10/14
______

1/15
______

Mo / Yr

Mo/Yr

3
0
Total ____Yrs.
________Mo.

Welding Fences, Fixing any broken metal items

12-16
Hours Per Week:_________
Reason For Leaving:

From:

Penn Villa 3540 Merced California 95340

_________________________________________________
_________________________________________________

Supervisors Name:
Hunter Phillips
_____________________________________________________

_________________________________________________

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.

Joshua Ducette

Complete Address (Include City, State, Zip)

Phone

Occupation_______

Palicort 3027 Turlock California 94387

________________________________________________________________________________________________________________________________
2. James

Garezell

University Drive 2454 Merced California 95340

________________________________________________________________________________________________________________________________
3. Michael

Phillips

Tres Logos Drive 3487 Merced California 95348

________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.

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

Date:_________________________Signature:_________________________________________________________________