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ROP APPLICATION

Directions: Please Print Legibly

Name: __________________________________________
Tovar Marco Alonso ____________________
5/13/19
(Last) (First) (Middle) Date

Present mailing address:___________________________________________________________


635 East Olive Ave
(P.O. Box or Street Number)

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

(209 ) 640-9017 ( )____________________ ____________________________


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

Position applied for:_______________________________________________________________


Calvin E. Bright Success Center Mentorship

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


- Self-directed work ethic with a direction to detail.
- Certified bilingual speaker from the Merced County Office of Education.
- Strong communication skills to allow teams to make dreams a reality.

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


Spanish

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:
- Gateway Scholars Program
- Apart of 2017-2018 Yearbook in Merced High School

FULL TIME
AVAILABILITY PART TIME

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

x x x
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.
Patrica Zarco Delhi, CA

________________________________________________________________________________________________________________________________

2. Ej Garcia Merced, CA

________________________________________________________________________________________________________________________________

3. Estrada Hidalgo Planada, CA

________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.


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

Date:_________________________Signature:_________________________________________________________________

N:\ROP\Charlotte Klock\ROP Forms\Forms\ROP Job Application with availbility back-for fillable.rtf Revised 7/10

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