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ROP APPLICATION
Directions: Please Print Legibly
Miao , Lisa
Name: __________________________________________

(Last)

(First)

03/27/16
____________________

(Middle)

Date

Present mailing address:___________________________________________________________

2195 Pinehurst Ct.
(P.O. Box or Street Number)
CA
Merced
95340
_______________________________________________________________________________

(City)

(State)

( 209 ) -201-8192
(Telephone Number)

(Zip Code)

lisa.miao1@yahoo.com
( 209 )____________________
____________________________
-761-4019
(Alternative Telephone Number)
(Email Address)

Denny's Hostess
Position applied for:_______________________________________________________________

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

Type 80 WPM, customer service, telephone etiquette, fast learner, friendly

Chinese
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

_______________________
Y2603201
(Number)

RECORD OF EDUCATION

Name of School
High School

College/
University

City/State

Course of
study or
major

Last year
completed

Did you
graduate?

Diploma
or degree

yes

Diploma

Merced High School

Merced/CA

na

1 2 3 4

UCSD

San Diego, CA

undecided

1 2 3 4

Other
(Specify)

1 2 3 4

List appropriate extracurricular activities, clubs, organizations and courses for this position:
Varsity Tennis 4 years, Key Club, Interact, Tennis Club, Decathlon Club, Reading, Biking, MERCOATA

FULL TIME

AVAILABILITY
SUNDAY

MONDAY

TUESDAY

2:45pm- 11pm 2:45pm- 11pm

WEDNESDAY

2:45pm- 11pm

PART TIME

THURSDAY

FRIDAY

2:45pm- 11pm 2:45pm- 11pm

SATURDAY

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

Period of Employment Job Title and Duties Performed
05/2013
From:
To: now
05/13
______

now
______

Mo / Yr

Mo/Yr

11
2
Total ____Yrs.
________Mo.

14
Hours Per Week:_________
Reason For Leaving:

From:

Company Name, Address, and Phone Number

Tokyo Don

140
Waitress
Title__________________________Last
Salary: _____________

_________________________________________________

Duties

_________________________________________________

Wait tables, take delivery and pick up orders from

phone, clean and clear tables, wash dishes, prepare
some foods, deliver orders.

_________________________________________________

(209)-388-9698

_________________________________________________

Supervisors Name:
Li Lan Chen
_____________________________________________________

_________________________________________________

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.

Complete Address (Include City, State, Zip)

Janice Jimenez

Phone

Occupation_______

(209)-769-3686

accountant
________________________________________________________________________________________________________________________________
2. Li

(209)-761--4019

Lan Chen

Restauranteur

Merced, CA 95348

________________________________________________________________________________________________________________________________
3.

Micky Lenahan

478 E Yosemite Ave # A

(209)-761-3228

Merced, CA 95340

accountant

________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.

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

Lisa Miao
Date:_________________________Signature:_________________________________________________________________
03/27/16

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

Revised 7/10