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ROP APPLICATION

Directions: Please Print Legibly

Name: __________________________________________
Anguiano Juan Manuel ____________________
5-17-19
(Last) (First) (Middle) Date

Present mailing address:___________________________________________________________


1428west 9th st
(P.O. Box or Street Number)

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

(209 ) 631-2863 ( )____________________ ____________________________


Juananguiano69611@gmail.com
(Telephone Number) (Alternative Telephone Number) (Email Address)

Position applied for:_______________________________________________________________


welder

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


1 year of supervised welding

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

College/ 1 2 3 4
University

Other
1 2 3 4
(Specify)

List appropriate extracurricular activities, clubs, organizations and courses for this position:
1 year of supervised welding

FULL TIME
AVAILABILITY PART TIME

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY


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:

9/18 9/18
Merced River AG Bosster
Title__________________________Last 0
Salary: _____________ _________________________________________________
______ ______
Mo / Yr Mo/Yr
Duties _________________________________________________
1
Total ____Yrs. 1
________Mo.
Helped serve and assemble food for an FFA _________________________________________________
6
Hours Per Week:_________ organization
Reason For Leaving: _________________________________________________

Supervisor’s Name: _________________________________________________


Steve Mua
_____________________________________________________

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.

________________________________________________________________________________________________________________________________

2.

________________________________________________________________________________________________________________________________

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:_________________________________________________________________

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

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