ROP APPLICATION

Directions: Please Print Legibly

Ellis
Steven
Anthony
Name: __________________________________________

(Last)

(First)

05/11/15
____________________

(Middle)

Date

1234 Army Ave.

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

CA
Merced
95348
_______________________________________________________________________________

(City)

(State)

(209 ) 123-3465

(Zip Code)

ArmyMP@gmail.com
145-8743
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)

(Telephone Number)

Position applied for:_______________________________________________________________

Secruity Officer
Skills and/or competencies which qualify you for this position:
Army Military Police Officer

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

Course of
study or
major

Merced, CA

College/
University

Basic
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:

FULL TIME

AVAILABILITY

PART TIME

SUNDAY

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

8am-4pm

8am-4pm

8am-4pm

8am-4pm

8am-4pm

8am-4pm

8am-4pm

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

Period of Employment
From:

Job Title and Duties Performed

Company Name, Address, and Phone Number

Army MP
Title__________________________Last
Salary: _____________

_________________________________________________

Duties

_________________________________________________

Provide military secruity and drills

_________________________________________________

To:

05/14
______

05/20
______

Mo / Yr

Mo/Yr

0
6
Total ____Yrs.
________Mo.
Hours Per Week:_________
Reason For Leaving:

From:

Army National Guard, RSP Fresno Air Base

_________________________________________________
Supervisors Name:
_____________________________________________________

_________________________________________________

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.

Hector Nava

Complete Address (Include City, State, Zip)

Phone

Occupation_______

205 W. Olive Ave. Merced, CA, 95344

Teacher

________________________________________________________________________________________________________________________________
2. SGT

Carr

Merced Armory, Merced, CA, 95341

National Guard

________________________________________________________________________________________________________________________________
3. SGT

Acosta

RSP Fresno Air Base

National Guard

________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.

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

Date:_________________________Signature:_________________________________________________________________