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ROP APPLICATION
Directions: Please Print Legibly
Romero
Alonzo
Robert
Name: __________________________________________

(Last)

(First)

April 14, 2016

____________________

(Middle)

Date

2601 B & B BLVD

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

California
95348
Merced
_______________________________________________________________________________

(City)

(State)

( 209 ) 658-6995

(Zip Code)

Aromero402136@muhsdstudents.org
( N/A )____________________ ____________________________
(Alternative Telephone Number)
(Email Address)

(Telephone Number)

Foot Locker
Position applied for:_______________________________________________________________

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

Experienced sales associate, organized, clean, welding, construction, woodcrafts,

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

Spanish
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 High School

Merced,
California

College/
University

N/A

Other
(Specify)

N/A

Course of
study or
major
General Ed

Last year
completed
1 2 3 4

Did you
graduate?

Diploma
or degree

Pending
2016

Pending
2016

1 2 3 4

1 2 3 4

List appropriate extracurricular activities, clubs, organizations and courses for this position:
FFA

FULL TIME

AVAILABILITY
SUNDAY

MONDAY

12:00pm-9:30pm 4pm-9:30pm

TUESDAY

4pm-9:30pm

WEDNESDAY

4pm-9:30pm

THURSDAY

4pm-9:30pm

FRIDAY

4pm-9:30pm

PART TIME

SATURDAY

12:00pm-9:30pm

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

_________________________________________________

To:

______

______

Mo / Yr

Mo/Yr

Total ____Yrs. ________Mo.

_________________________________________________
Hours Per Week:_________
Reason For Leaving:

From:

_________________________________________________
Supervisors Name:
_____________________________________________________

_________________________________________________

Title__________________________Last
Salary: _____________
N/A

_________________________________________________

Duties:

_________________________________________________

To:

______

______

Mo/ Yr

Mo/Yr

Total ____Yrs. ________Mo.

_________________________________________________

Hours Per Week:_________

Reason For Leaving:

_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________

From:

To:

______

______

Mo /Yr

Mo/Yr

N/A
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.

Daniel Vargas

Complete Address (Include City, State, Zip)

3627 West Yosemite Ave, Merced Ca 95348

Phone

(209)756-3245

Occupation_______

Mechanic

________________________________________________________________________________________________________________________________
2. Lourdes

Mora

6773 Orleander Ave, Merced Ca 95348

(209)748-8734
Bank teller

________________________________________________________________________________________________________________________________
3.

Matt Bales

2789 Ranchero Lane, Merced Ca 95340

(599)474-7436

Electrician

________________________________________________________________________________________________________________________________

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