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ROP APPLICATION
Directions: Please Print Legibly

Name: __________________________________________
Kolb Ethan Timothy Jiang ____________________
5/12/19
(Last) (First) (Middle) Date

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

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

(209 ) 947-7214 ( 209 )____________________

722-8230 ____________________________
ekolb12371237@gmail.com
(Telephone Number) (Alternative Telephone Number) (Email Address)

Position applied for:_______________________________________________________________

File Clerk at Berliner Cohen Lawfirm

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

Public Speaking, work well with others, proficient in computer applications, knowledge of AU equipment,
efficient worker

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

N/A

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 _______________________
Y4684426
(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 N/A 1 2 3 4 No No

College/ 1 2 3 4
Fresno State University Fresno, CA Business No No
University

Other
Merced Junior College Merced, Ca N/A 1 2 3 4 No No
(Specify)

List appropriate extracurricular activities, clubs, organizations and courses for this position:
MHS Leadership, Merced Youth Council, Merced Student Site Council, Junior Leadership Merced, Merced High
School Leo Club

FULL TIME
AVAILABILITY PART TIME

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

x x 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:
N/A
Title__________________________Last N/A
Salary: _____________
N/A
_________________________________________________
N/A
______ N/A
______
Mo / Yr Mo/Yr
Duties _________________________________________________
N/A
Total ____Yrs. N/A
________Mo.
N/A _________________________________________________
N/A
Hours Per Week:_________
Reason For Leaving: _________________________________________________
N/A
Supervisor’s Name: _________________________________________________
N/A
_____________________________________________________

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

_________________________________________________
Supervisor’s Name:
________________________________________________

From: To:
Title___________________________Last Salary: ____________ _________________________________________________
N/A
______ ______
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.
Lam Kindavang 678 W 18th St. Merced, CA, 95340 209-385-6834
Events Cordinator
________________________________________________________________________________________________________________________________

2. Lisa Carr 2844 Park Aev, Merced, CA, 95348 209-385-0700

HR Director
________________________________________________________________________________________________________________________________

3. Marine Zuzlewski 945 Buena Vista Dr, Merced CA, 95348 209-724-2550
ElementaryTeacher
________________________________________________________________________________________________________________________________

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