ROP APPLICATION

Directions: Please Print Legibly

Cordero
Gabriel
Paul
Name: __________________________________________

(Last)

(First)

February 8, 2016
____________________

(Middle)

Date

3217 Erie Avenue

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

California
Merced
95340
_______________________________________________________________________________

(City)

( 209 ) 947-2759
(Telephone Number)

(State)

(Zip Code)

gabielbaker97@yahoo.com
947-8612
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)

Position applied for:_______________________________________________________________

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

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

not applicable
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

High School

Name of School

City/State

Merced Highschool

Merced/CA

College/
University

not applicable

Other
(Specify)

not applicable

Course of
study or
major

Last year
completed
1 2 3 4

Did you
graduate?

Diploma
or degree

not yet

1 2 3 4

1 2 3 4

List appropriate extracurricular activities, clubs, organizations and courses for this position:
President of League of Legends Club

FULL TIME

AVAILABILITY
SUNDAY

MONDAY

TUESDAY

WEDNESDAY

PART TIME

THURSDAY

FRIDAY

SATURDAY

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

Period of Employment
From:

Job Title and Duties Performed

Company Name, Address, and Phone Number

unpaid
Poolboy
Title__________________________Last
Salary: _____________

_________________________________________________

Duties

_________________________________________________

Clean pools

_________________________________________________

To:

05/15
______

08/15
______

Mo / Yr

Mo/Yr

0
3
Total ____Yrs.
________Mo.

3217 Erie Avenue, Merced, CA 95340

27
Hours Per Week:_________
Reason For Leaving:
School started

From:

_________________________________________________
Supervisors Name:
Sherry Baker
_____________________________________________________

_________________________________________________

unpaid
Title__________________________Last
Salary: _____________
Camerman

_________________________________________________

Duties:

_________________________________________________

Video record high-school sports

_________________________________________________

To:

08/15
______

02/16
______

Mo/ Yr

Mo/Yr

6
0
Total ____Yrs.
________Mo.

Merced Highschool

205 W Olive Ave, Merced, CA 95348

Hours Per Week:_________

4
Reason For Leaving:

(209) 385-6465

_________________________________________________
_________________________________________________

Times becoming
unpleasent

From:

Central Valley Pools

Supervisors Name:
Keith Petiti
________________________________________________
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.

________________________________________________________________________________________________________________________________
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