ROP APPLICATION

Directions: Please Print Legibly

Name: __________________________________________
Murshed Jawaher ____________________
May 5 2017
(Last) (First) (Middle) Date

Present mailing address:___________________________________________________________

864 Mather road
(P.O. Box or Street Number)

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

(209 ) 723 4367 ( 209 )____________________

5009974 ____________________________
(Telephone Number) (Alternative Telephone Number) (Email Address)

Position applied for:_______________________________________________________________

Vet Assistant

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

Love animals
Hard worker
Team Player

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

Arabian

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
Course of
study or Last year Did you Diploma
Name of School City/State major completed graduate? or degree
High School Merced High School Merced 1 2 3 4 current

College/ 1 2 3 4
University

Other
1 2 3 4
(Specify)

List appropriate extracurricular activities, clubs, organizations and courses for this position:
N/A

FULL TIME
AVAILABILITY PART TIME

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

8am-5pm 8am-5Pm 8am-5pm 8am-5pm 8am-5pm 8am-5pm 8am-5pm

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

Supervisors Name: _________________________________________________

_____________________________________________________

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

_________________________________________________
Supervisors Name:
________________________________________________

From: To:
N/A
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.
Karnia Ceja 1220 west 9th street 209 563-4874

________________________________________________________________________________________________________________________________

2. Joshua Rashe 3360 san rafeal ct. 575 649-1052

________________________________________________________________________________________________________________________________

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:_________________________________________________________________