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ROP APPLICATION
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Juan
Carlos
Name: Villa-Negrete
__________________________________________
(Last)
(First)
05/08/2015
____________________
(Middle)
Date
(City)
(State)
(209 )
)____________________ jvillanegrete@yahoo.com
____________________________
(Telephone Number)
(Zip Code)
(Email Address)
Engineering Internship
Position applied for:_______________________________________________________________
Spanish
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:________________________________
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
In Progress
Diploma
1 2 3 4
Merced High
Merced
General Ed
College/
University
1 2 3 4
Other
(Specify)
1 2 3 4
List appropriate extracurricular activities, clubs, organizations and courses for this position:
School Site Council, FBLA, M.E.Ch.A, French Club, Claws Council.
FULL TIME
AVAILABILITY
PART TIME
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
No
Yes
Yes
Yes
Yes
Yes
Yes
Agriculture
$9.00/ hour
Title__________________________Last
Salary: _____________
Rodriguez
Labor
_________________________________________________
Duties
_________________________________________________
_________________________________________________
To:
06/2014
______
08/2014
______
Mo / Yr
Mo/Yr
2
Total ____Yrs. ________Mo.
45
Hours Per Week:_________
Reason For Leaving:
_________________________________________________
Supervisors Name:
Rodrigues
_____________________________________________________
To:
12/2014
______
01/2015
______
Mo/ Yr
Mo/Yr
1
Total ____Yrs. ________Mo.
45
Hours Per Week:_________
Reason For Leaving:
School started, I only
wanted to work during
winter break.
From:
_________________________________________________
$9.00/ hour
Title__________________________Last
Salary: _____________
Agriculture
Rodriguez
Labor
_________________________________________________
Duties:
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
Supervisors Name:
Rodrigues
________________________________________________
To:
______
______
Mo /Yr
Mo/Yr
_________________________________________________
Duties:
_________________________________________________
_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________
_________________________________________________
Phone
Occupation_______
Sarah Morgan
(209) 385-6465
Teacher Librarian
________________________________________________________________________________________________________________________________
2.
(209) 385-6465
Joseph Gaestel
Technology Instructo
________________________________________________________________________________________________________________________________
3.
Andrea Deleon
(209) 385-6465
English Teacher
________________________________________________________________________________________________________________________________
Date:_________________________Signature:_________________________________________________________________
Revised 7/10