ROP APPLICATION

Directions: Please Print Legibly

Name: __________________________________________
Yang Steven ____________________
04/12/2018
(Last) (First) (Middle) Date

Present mailing address:___________________________________________________________

2432 Driftwood Dr.
(P.O. Box or Street Number)

Merced CA 95348
_______________________________________________________________________________
(City) (State) (Zip Code)

(209 ) 205-0358 ( )____________________ ____________________________

(Telephone Number) (Alternative Telephone Number) (Email Address)

Position applied for:_______________________________________________________________

Cashier/ Cook

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

I am good at math and have 97% attendance in school. I am always want to learn new things like cooking. I
obey the rules and listen to what I'm told to do.

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

Hmong

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 Driver’s 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, CA Math 1 2 3 4 yes Diploma

College/ 1 2 3 4
University

Other
1 2 3 4
(Specify)

List appropriate extracurricular activities, clubs, organizations and courses for this position:
I play volleyball to keep my body in shape. I joined Leo and Kiwanis to develop my leadership skills.

FULL TIME
AVAILABILITY PART TIME

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

no no yes no yes yes no

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

Supervisor’s Name: _________________________________________________

_____________________________________________________

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

_________________________________________________
Supervisor’s Name:
________________________________________________

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

_________________________________________________
Supervisor’s Name:
________________________________________________

REFERENCES: Give the names of three persons not related to you.

Name Complete Address (Include City, State, Zip) Phone Occupation_______
1.
John Long 205 W Olive Ave, Merced, CA 95348
English Teacher
________________________________________________________________________________________________________________________________

2. Sher Kyle Xiong 958 Lehigh Dr, Merced, CA 95348 (209) 769-3632
School Security
________________________________________________________________________________________________________________________________

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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