Professional Documents
Culture Documents
Rop Application: Directions: Please Print Legibly
Rop Application: Directions: Please Print Legibly
ROP APPLICATION
Directions: Please Print Legibly
Name: __________________________________________
thao thomas koua ____________________
5,18,19
(Last) (First) (Middle) Date
Have you ever been convicted, pleaded guilty or no contest to a misdemeanor or felony?
No Yes If yes, explain:________________________________
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 Merced CA General 1 2 3 4 pending pending
education 2019 2019
College/ 1 2 3 4
NA
University
Other
NA 1 2 3 4
(Specify)
List appropriate extracurricular activities, clubs, organizations and courses for this position:
Adventure Club, Leo Club, Mountain Sports Club
FULL TIME
AVAILABILITY PART TIME
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: _________________________________________________
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:
________________________________________________
Date:_________________________Signature:_________________________________________________________________
N:\ROP\Charlotte Klock\ROP Forms\Forms\ROP Job Application with availbility back-for fillable.rtf Revised 7/10