Job Application

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ROP APPLICATION
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Jayce
C.
Name: Peterson
__________________________________________
(Last)
(First)
5/12/14
____________________
(Middle)
Date
2679 E. Cardella Rd.

Present mailing address:___________________________________________________________
(P.O. Box or Street Number)

CA
Merced
95340
_______________________________________________________________________________
(City)
(209 ) 819-1204
(State)
)____________________ [email protected]
____________________________
(Telephone Number)
(Zip Code)
(Alternative Telephone Number)
(Email Address)
Dry Yard Manager

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

Hard working
Dedicated
Responsible
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 Drivers License?

No
Yes
_______________________
(Number)
RECORD OF EDUCATION
Name of School
Course of
study or
major
City/State
High School
Last year
completed
Did you
graduate?
Diploma
or degree
1 2 3 4
Merced High School
Merced/CA
Still Enrolled
College/
University
1 2 3 4
Other
(Specify)
1 2 3 4
List appropriate extracurricular activities, clubs, organizations and courses for this position:
FFA,football
FULL TIME
AVAILABILITY
PART TIME
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
none
any
any
any
any
any
8-5
RECORD OF EMPLOYMENT: (Begin with your most recent job)

Period of Employment
From:
Job Title and Duties Performed
Company Name, Address, and Phone Number
Box Maker
8 per hour
Title__________________________Last
Salary: _____________
Passion
Fruit Farms
_________________________________________________
Duties
6493
E. Olive Ave.
_________________________________________________
Make boxes for figs,and refill fig bins.
(209)725-3447
_________________________________________________
To:
06/13
______
current
______
Mo / Yr
Mo/Yr
11
Total ____Yrs. ________Mo.
40
Hours Per Week:_________
Reason For Leaving:
_________________________________________________
Supervisors Name:
Tonetta Gladwin
_____________________________________________________
From:
To:
3/14
______
5/14
______
Mo/ Yr
Mo/Yr
Total ____Yrs. ________Mo.
10
Reason For Leaving:
_________________________________________________
10 per hour
Title__________________________Last
Salary: _____________
Mechanic
Rj
Auto Body
_________________________________________________
Duties:
1308
E. Childs Ave.
_________________________________________________
Sanded/Prepped cars for paint. Also fixed cars that

needed maintenance.
(209)489-8770
_________________________________________________
_________________________________________________
Did not pay well.
_________________________________________________
Supervisors Name:
Robert Teague
________________________________________________
From:
To:
______
______
Mo /Yr
Mo/Yr
Title___________________________Last Salary: ____________
_________________________________________________
Duties:
_________________________________________________
Total ____Yrs. ________Mo.
_________________________________________________

Reason For Leaving:
_________________________________________________
Supervisors Name:
________________________________________________
_________________________________________________
REFERENCES: Give the names of three persons not related to you.

Name
1.
Complete Address (Include City, State, Zip)
Phone
Occupation_______
6493 E. Olive Ave. Merced CA 95340
Tonetta Gladwin
(209)725-3447
Business Owner
________________________________________________________________________________________________________________________________
6493 E. Olive Ave. Merced CA 95340
2.
(209)617-0112
Blair Gladwin
Business Owner
________________________________________________________________________________________________________________________________
2121 E. Childs Ave. Merced CA 95341
3.
Cody Jacobsen
(209)385-6592
Ag Teacher
________________________________________________________________________________________________________________________________
I authorize investigation of all statements contained in this application.

I understand that misrepresentation or omission of facts is cause for dismissal.
Date:_________________________Signature:_________________________________________________________________
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2679 E. Cardella Rd.

(P.O. Box or Street Number)

(Alternative Telephone Number)

Dry Yard Manager

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

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

Do you possess a valid California Drivers License?

Merced High School

RECORD OF EMPLOYMENT: (Begin with your most recent job)

Job Title and Duties Performed

Company Name, Address, and Phone Number

Make boxes for figs,and refill fig bins.

Total Yrs. ____Mo.

Sanded/Prepped cars for paint. Also fixed cars that

Did not pay well.

Title_______________Last Salary:

Total Yrs. ____Mo.

Hours Per Week:_________

REFERENCES: Give the names of three persons not related to you.

Complete Address (Include City, State, Zip)

6493 E. Olive Ave. Merced CA 95340

6493 E. Olive Ave. Merced CA 95340

2121 E. Childs Ave. Merced CA 95341

I authorize investigation of all statements contained in this application.

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

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