ROP APPLICATION

Directions: Please Print Legibly

Gonzales
Marina
Luise
Name: __________________________________________

(Last)

(First)

May 8, 2014
____________________

(Middle)

Date

1036 V Street
Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

California
Merced
95341
_______________________________________________________________________________

(City)

(State)

(209 ) 658-1574

(Zip Code)

mgonzales12041995@gmail.com
658-9812
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)

(Telephone Number)

Position applied for:_______________________________________________________________

Classroom Assistant
Skills and/or competencies which qualify you for this position:
Ability to work with others while having a positive attitude.
Working on hands on ativities that require tools.
Honest/ Reliable worker.
N/A
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
High School

Course of
study or
major

City/State

Last year
completed

Did you
graduate?

Diploma
or degree

Merced High School

Merced
California

General
Education

1 2 3 4

Pending
2014

Diploma

College/
University

N/A

N/A

N/A

1 2 3 4

N/A

N/A

Other
(Specify)

N/A

N/A

N/A

1 2 3 4

N/A

N/A

List appropriate extracurricular activities, clubs, organizations and courses for this position:
ROP Foundations in Education
Volunteer work at OLM (Our Lady of Mercy) School during Catehism hours (4:15-5:30 pm)
FULL TIME

AVAILABILITY

PART TIME

SUNDAY

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

N/A

4:00-7:00PM

4:00-7:00PM

N/A

4:00-6:00PM

4:00-7:00PM

N/A

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

Period of Employment
From:

Company Name, Address, and Phone Number

Class Credit
Classroom Assistant
Title__________________________Last
Salary: _____________

_________________________________________________

Duties

_________________________________________________

Assist the teacher in helping the students with

classwork or activities they don't understand.

_________________________________________________

To:

11/13
______

Present
______

Mo / Yr

Mo/Yr

Total ____Yrs. ________Mo.

4 1/2
Hours Per Week:_________
Reason For Leaving:

From:

Job Title and Duties Performed

3200 N. Parsons Avenue

Present
______

Mo/ Yr

Mo/Yr

21
3
Total ____Yrs.
________Mo.
Hours Per Week:_________
1hr15min
Reason For Leaving:

Merced, California 95340

(209) 385-6620

_________________________________________________

Principal Mr. Vance d'Escoto

Supervisors Name:
Mrs. Dolores Montanez
_____________________________________________________

_________________________________________________

Com. Service
Title__________________________Last
Salary: _____________
Classroom Assistant

_________________________________________________

Duties:

_________________________________________________

To:

9/11
______

Chenoweth Elementary School

Our Lady of Mercy School

1400 E. 27th Street

Assist the teacher during OLM Catechism hours in

helping the students learn the lesson and
complete...

Merced, California 95341

_________________________________________________

(209) 722-7496

_________________________________________________

Catechism Director Debbie Rosa

_________________________________________________
Supervisors Name:
Debbie Rosa
________________________________________________
From:

To:

______

______

Mo /Yr

Mo/Yr

N/A
N/A
Title___________________________Last
Salary: ____________

_________________________________________________

Duties:

_________________________________________________

Total ____Yrs. ________Mo.

_________________________________________________

Hours Per Week:_________

Reason For Leaving:

_________________________________________________

Supervisors Name:
________________________________________________

_________________________________________________

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

Name
1.

Dolores Montanez

Complete Address (Include City, State, Zip)

3200 North Parsons Avenue

Phone

Occupation_______

(209) 385-6620
Teacher

Merced, California 95340

________________________________________________________________________________________________________________________________
2. William

"Bill" Freitas

205 West Olive Avenue

(209) 384-0280
Teacher

Merced, California 95348-3100

________________________________________________________________________________________________________________________________
3. Donna

Acheson

205 West Olive Avenue

(209) 631-3164

Mecred, California 95348-3100

ROP Instructor

________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.

I understand that misrepresentation or omission of facts is cause for dismissal.

Date:_________________________Signature:_________________________________________________________________