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Name: __________________________________________
Sarkar Krishnamurti Jan ____________________
4-8-18
(Last) (First) (Middle) Date
Merced CA 95348
_______________________________________________________________________________
(City) (State) (Zip Code)
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 School Merced N/A 1 2 3 4 N/A N/A
College/ 1 2 3 4
N/A N/A N/A N/A N/A
University
Other
N/A N/A N/A 1 2 3 4 N/A N/A
(Specify)
List appropriate extracurricular activities, clubs, organizations and courses for this position:
FULL TIME
AVAILABILITY PART TIME
x x x x
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:
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:
________________________________________________
________________________________________________________________________________________________________________________________
2.
________________________________________________________________________________________________________________________________
3.
________________________________________________________________________________________________________________________________
Date:_________________________Signature:_________________________________________________________________