ROP APPLICATION

Directions: Please Print Legibly

Lua
Alexa
Michelle
Name: __________________________________________

(Last)

(First)

05/7/15
____________________

(Middle)

Date

1129 Sentinel Ct.

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

CA
Merced
95340
_______________________________________________________________________________

(City)

(State)

(209 ) 658-3382
(Telephone Number)

(Zip Code)

alexamichellelua@gmail.com
383-6337
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)

Position applied for:_______________________________________________________________

Graphic Design Internship
Skills and/or competencies which qualify you for this position:
I can draw, paint, and sculpt, whcih are all necessary to the graphic design process. I am also a very
diligent and effiicient worker, as well as an attentive listener.

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
High School

Course of
study or
major

City/State

Merced High School

Merced, CA

College/
University

Last year
completed

Did you
graduate?

Diploma
or degree

1 2 3 4

June 2015

Diploma

1 2 3 4

Other
(Specify)

1 2 3 4

List appropriate extracurricular activities, clubs, organizations and courses for this position:
Art Club, Summer History Program Model Building Committee, Academic Decathlon Art History course, Key
Club Creativity Director
FULL TIME

AVAILABILITY

PART TIME

SUNDAY

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

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

Period of Employment
From:

Company Name, Address, and Phone Number

$960.00
Restaurant Hostess
Title__________________________Last
Salary: _____________

_________________________________________________

Duties

_________________________________________________

To:

06/14
______

09/14
______

Mo / Yr

Mo/Yr

3
Total ____Yrs. ________Mo.
10
Hours Per Week:_________
Reason For Leaving:
School

From:

Job Title and Duties Performed

La Hacienda

147 G Street

Welcoming and seating customers. Taking drink

orders, and supplying refreshments. Cleaning
tables.

(209)726-7700

_________________________________________________
_________________________________________________

Supervisors Name:
Irma Lua
_____________________________________________________

_________________________________________________

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.

Irma Lua

Complete Address (Include City, State, Zip)

1129 Sentinel Ct. Merced CA 95340

Phone

Occupation_______

(209)201-5792
Management

________________________________________________________________________________________________________________________________
2.

________________________________________________________________________________________________________________________________
3.

________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.

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

Date:_________________________Signature:_________________________________________________________________