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ROP APPLICATION
Directions: Please Print Legibly

Name: __________________________________________
Chang Lucy ____________________
April 12, 2017
(Last) (First) (Middle) Date

Present mailing address:___________________________________________________________

2221 birchwood ct
(P.O. Box or Street Number)

Merced CA
_______________________________________________________________________________
95341
(City) (State) (Zip Code)

( 209 ) 201-7038 ( )____________________ ____________________________

lucychang73@gmail.com
(Telephone Number) (Alternative Telephone Number) (Email Address)

Position applied for:_______________________________________________________________

KIndergarten Teacher

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

I qualify for this position because I am a hardworking, empathetic and Tolerant individual with a passion to
help others. I love being around children and feel that I have the potential to be a good role model.

Hmong
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 _______________________
Y3045865
(Number)

RECORD OF EDUCATION
Course of
study or Last year Did you Diploma
Name of School City/State major completed graduate? or degree
High School 1 2 3 4
Merced High School Merced, CA None Not Yet Pending

College/ 1 2 3 4
University

Other
1 2 3 4
(Specify)

List appropriate extracurricular activities, clubs, organizations and courses for this position:
I am currently a officer, in the position of secretary, for Asian Club and also a member of Leo Club.

FULL TIME
AVAILABILITY PART TIME

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

9:00-5:00 7:30-3:00 7:30-3:00 7:30-3:00 7:30-3:00

7:30-3:00 9:00-4:00
RECORD OF EMPLOYMENT: (Begin with your most recent job)

Period of Employment Job Title and Duties Performed Company Name, Address, and Phone Number
From: To:
05/2015 Cashier/server
Title__________________________Last 05/10/2017
Salary: _____________ Merced Union High School district
_________________________________________________
______ 05/2017
______
Mo / Yr Mo/Yr 205 w Olive Ave
Duties _________________________________________________
2
Total ____Yrs. ________Mo. Handle all cash transactions, serve food to students, Merced, CA 95348
_________________________________________________
Hours Per Week:_________ keep work area clean and tidy and restock snacks (209)631-4931
Reason For Leaving: _________________________________________________
still present
Supervisors Name: _________________________________________________
Silvia Garcia
_____________________________________________________

From: To:
Title__________________________Last Salary: _____________ _________________________________________________
______ ______
Mo/ Yr Mo/Yr Duties: _________________________________________________
Total ____Yrs. ________Mo. _________________________________________________
Hours Per Week:_________
Reason For Leaving: _________________________________________________

_________________________________________________
Supervisors Name:
________________________________________________

From: To:
Title___________________________Last Salary: ____________ _________________________________________________
______ ______
Mo /Yr Mo/Yr 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:_________________________________________________________________

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