ROP APPLICATION

Directions: Please Print Legibly

Name: __________________________________________
Gaddess Kaitlyn Nicole ____________________
04/10/2018
(Last) (First) (Middle) Date

Present mailing address:___________________________________________________________

250 Seneca St.
(P.O. Box or Street Number)

Merced Ca 95340
_______________________________________________________________________________
(City) (State) (Zip Code)

(209 ) 947-8670 ( )____________________ ____________________________

68kaitlynn@gmail.com
(Telephone Number) (Alternative Telephone Number) (Email Address)

Position applied for:_______________________________________________________________

Open

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

communication skills
works well with others

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 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 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:

FULL TIME
AVAILABILITY PART TIME

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

3:30-10 3:30-10 3:30-10 3:30-10 3:30-10

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.
Alex Murro 205 W Olive Ave, Merced, CA 95348 (209)325-1019
attendance liason
________________________________________________________________________________________________________________________________

2. Noemi Castellanos 3145 Meadows Ave apt 95 Merced CA 95340 (209)756-8886

n/a
________________________________________________________________________________________________________________________________

3. Ivette Guzman 511 Applegate Rd. Atwater CA 95301 (209)489-6965

n/a
________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.

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

Date:_________________________Signature:_________________________________________________________________