ROP APPLICATION

Directions: Please Print Legibly

Gonzalez-Melendez Josue
Daniel
Name: __________________________________________

(Last)

(First)

05/02/2015
____________________

(Middle)

Date

1255 Wildcat DR.

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

California
Merced
95348
_______________________________________________________________________________

(City)

(State)

(570 ) 939-9745

(Zip Code)

jgonzalezmelendez103633@muhsdstu
349 8167
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)

(Telephone Number)

Position applied for:_______________________________________________________________

Internship at Yosemite Church
Skills and/or competencies which qualify you for this position:
Encouraging, spiritually growing, mentor capabilities, discernment, spiritual gifts.
Experience volunteering at middle school youth, and evangilizing on a missionary trip.

N/A
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 Highschool

Course of
study or
major

Last year
completed

Did you
graduate?

Diploma
or degree

N/A

1 2 3 4

Yes

Diploma

Merced, CA

College/
University

N/A

1 2 3 4

Other
(Specify)

N/A

1 2 3 4

List appropriate extracurricular activities, clubs, organizations and courses for this position:
Son Seeker's at Merced High School
Various youth groups - Yosemite Church's, Christian Life Center
Church's

Young Life, volunteer at Yosemite

FULL TIME

AVAILABILITY
SUNDAY

10 AM - 4 PM

MONDAY

TUESDAY

10 AM - 8 PM 10 AM - 2 PM

WEDNESDAY

10 AM - 2 PM

PART TIME

THURSDAY

FRIDAY

SATURDAY

10 AM - 1 PM 10 AM - 5 PM 10 AM - 8 PM

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

Period of Employment
From:

Job Title and Duties Performed

Company Name, Address, and Phone Number

N/A
Title__________________________Last
Salary: _____________

_________________________________________________

Duties

_________________________________________________

N/A

_________________________________________________

To:

N/A
______

______

Mo / Yr

Mo/Yr

Total ____Yrs. ________Mo.

Hours Per Week:_________
Reason For Leaving:

From:

_________________________________________________
Supervisors Name:
N/A
_____________________________________________________

_________________________________________________

Title__________________________Last
Salary: _____________
N/A

_________________________________________________

Duties:

_________________________________________________

N/A

_________________________________________________

To:

N/A
______

______

Mo/ Yr

Mo/Yr

Total ____Yrs. ________Mo.

Hours Per Week:_________
Reason For Leaving:

_________________________________________________
_________________________________________________
Supervisors Name:
N/A
________________________________________________

From:

To:

N/A
______

______

Mo /Yr

Mo/Yr

Total ____Yrs. ________Mo.

N/A
Title___________________________Last
Salary: ____________

_________________________________________________

Duties:

_________________________________________________

N/A

_________________________________________________

Hours Per Week:_________

Reason For Leaving:

_________________________________________________

Supervisors Name:
N/A
________________________________________________

_________________________________________________

REFERENCES: Give the names of three persons not related to you.

Name
1.

Collin Kerrigan

Complete Address (Include City, State, Zip)

1252 La Playa Ave, Merced, CA, 95348

Phone

Occupation_______

805-704-5621
Youth Pastor

________________________________________________________________________________________________________________________________
2.

Jen Williams

4432 Primavera DR, Merced, CA, 95348

209-769-1387
Youth Director

________________________________________________________________________________________________________________________________
3. Jeff

Thun

5567 Loughborough ST, Merced, CA 95348

325-669-7899
Intern at Yosemite C

________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.

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

Date:_________________________Signature:_________________________________________________________________