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ROP APPLICATION
Directions: Please Print Legibly
Krumm
Baylee
Nicole
Name: __________________________________________

(Last)

(First)

8 February 2016
____________________

(Middle)

Date

1293 Baxter Drive

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

California
95348
Merced
_______________________________________________________________________________

(City)

(State)

( 209 ) 777-1183

(Zip Code)

bayleenickle@gmail.com
N/A
(
)____________________
____________________________
(Alternative Telephone Number)
(Email Address)

(Telephone Number)

Position applied for:_______________________________________________________________

Team Member
Skills and/or competencies which qualify you for this position:
Leadership skills, Ability to work on a team, public speaking skills, money management, responsible, hard
working.

Languages spoken and/or written (other than English):___________________________________

N/A
Have you ever been convicted, pleaded guilty or no contest to a misdemeanor or felony?
No

Yes

If yes, explain:________________________________
N/A

Do you possess a valid California Drivers License?

No

Yes

_______________________
F7276204

(Number)

RECORD OF EDUCATION

Name of School

City/State

Course of
study or
major

Merced High School

Merced,
California

General
Education

College/
University

N/A

N/A

N/A

Other
(Specify)

N/A

N/A

N/A

High School

Last year
completed
1 2 3 4

1 2 3 4

1 2 3 4

Did you
graduate?

Diploma
or degree

Pending
June 2016

Pending
June 2016

N/A

N/A

N/A

N/A

List appropriate extracurricular activities, clubs, organizations and courses for this position:
National FFA organization, Future Homemakers of America, Agriculture Leadership, Computer Applications,
Showing at Merced County Fair.
FULL TIME

AVAILABILITY
SUNDAY

7 am- 10pm

MONDAY

5pm-10pm

TUESDAY

5pm-10pm

WEDNESDAY

5pm-10pm

THURSDAY

5pm-10pm

FRIDAY

5pm-10pm

PART TIME

SATURDAY

7 am-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

$9/hr
Office Help
Title__________________________Last
Salary: _____________

_________________________________________________

Duties

_________________________________________________

Answer Phones, Organize office, make phone calls,

File Paperwork

_________________________________________________

To:

1/12
______

8/15
______

Mo / Yr

Mo/Yr

3
7
Total ____Yrs.
________Mo.

30
Hours Per Week:_________
Reason For Leaving:
Personal

From:

Grater Merced Chamber of Commerce

1640 N street

Merced, California 95348

(209)384-7092

_________________________________________________
Supervisors Name:
Jennifer Krumm
_____________________________________________________

_________________________________________________

NA
Title__________________________Last
Salary: _____________
NA

_________________________________________________

Duties:

_________________________________________________

NA

_________________________________________________

To:

NA
______

NA
______

Mo/ Yr

Mo/Yr

NA
Total ____Yrs. ________Mo.

NA

Hours Per Week:_________

Reason For Leaving:

_________________________________________________
_________________________________________________

NA
Supervisors Name:
NA
________________________________________________
From:

To:

NA
______

NA
______

Mo /Yr

Mo/Yr

NA
Total ____Yrs.
________Mo.

NA
NA
Title___________________________Last
Salary: ____________

_________________________________________________

Duties:

_________________________________________________

NA

_________________________________________________

NA

NA
Hours Per Week:_________
Reason For Leaving:

NA

_________________________________________________

Supervisors Name:
NA
________________________________________________

_________________________________________________

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

Name
1.

Lauren Elliott

Complete Address (Include City, State, Zip)

205 W Olive Ave, Merced, California 95348

Phone

(209) 385-8029

Occupation_______

Agriculture Teacher

________________________________________________________________________________________________________________________________
2. Steven

Mua

205 W Olive Ave, Merced, California 95348

(209) 385-8029
Agriculture Teacher

________________________________________________________________________________________________________________________________
3.

Andrew Calzadillas

205 W Olive Ave, Merced, California 95348

(209) 985-0322

Culinary Teacher

________________________________________________________________________________________________________________________________

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