ROP APPLICATION

Directions: Please Print Legibly

Stanford
Chad
Allen
Name: __________________________________________

(Last)

(First)

02/8/16
____________________

(Middle)

Date

193 Alpine Dr.

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

California
Merced
95340
_______________________________________________________________________________

(City)

(State)

( 209 ) 6284611

(Zip Code)

cstanford103394@gmail.com
7224553
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)

(Telephone Number)

Deputy Sheriff
Position applied for:_______________________________________________________________

Skills and/or competencies which qualify you for this position:

I am a strong leader and don't panic in an intense situation. I can think i way around problems and work well
with others. I don't fold under pressure.

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:________________________________
weapon possession in high school.

Do you possess a valid California Drivers License?

No

Yes

_______________________

(Number)

RECORD OF EDUCATION

High School

Name of School

City/State

Course of
study or
major

Merced HIgh school

Merced Ca.

GED

College/
University

Last year
completed
1 2 3 4

Did you
graduate?

Diploma
or degree

yes

HIgh
School
Diploma

1 2 3 4

Other
(Specify)

1 2 3 4

List appropriate extracurricular activities, clubs, organizations and courses for this position:
I took FFA for all four years.

AVAILABILITY
SUNDAY

4:00 - 4:00

MONDAY

4:00 -4:00

TUESDAY

4:00 - 4:00

WEDNESDAY

4:00 - 4:00

FULL TIME
PART TIME

THURSDAY

4:00 - 4:00

FRIDAY

4:00 - 4:00

SATURDAY

4:00 - 4:00

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

Period of Employment
From:

Job Title and Duties Performed

Company Name, Address, and Phone Number

Title__________________________Last Salary: _____________

_________________________________________________

Duties

_________________________________________________

To:

______

______

Mo / Yr

Mo/Yr

Total ____Yrs. ________Mo.

_________________________________________________
Hours Per Week:_________
Reason For Leaving:

From:

_________________________________________________
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

Complete Address (Include City, State, Zip)

Phone

Occupation_______

1.

Kevin Rocha

(209)-564-6116

Truck Driver

________________________________________________________________________________________________________________________________
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:_________________________________________________________________

N:\ROP\Charlotte Klock\ROP Forms\Forms\ROP Job Application with availbility back-for fillable.rtf

Revised 7/10