Employment Application Online Rafael Lumber & Building Supply Online Application Rafael Lumber 930 Andersen Dr. San Rafael CA 94901 (415)456-3043 employment@rafael-lumber.com Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Alt. PhoneEmail *Are you at least 18 years of age? (If under 18, hire is subject to verification of minimum legal age possessing a work permit)YesNo*Do you have a legal right to work in the U.S.? (Proof of eligibility and identification required upon hire.)YesNo*If hired would you have a reliable means of transportation to and from work?YesNo*Are you able to perform the essential functions of the job for which you're applying, either with or without reasonable accommodations?YesNoIf no, describe the functions that cannot be performed:(Note: We comply with the ADA and consider reasonable accommodations that may be needed for eligible applicants/Employees to perform essential functions. Hire may be subject to passing a medical examination, and skill and agility tests.)*Have you ever applied to or worked for Rafael Lumber?YesNoIf yes, when and where:Position Desired*Pick One:Window and Door SalesPlumbing SalesCounter SalesContractor SalesYard/Shed PositionPaint SalesElectrical SalesTool SalesHardware SalesCashierManagmentDelivery DriversRecievingSalary DesiredDate available for Employment* Date Format: MM slash DD slash YYYY Status Desired* Regular Full-Time (40 hrs) Regular Part-Time (20-39.9 hrs) Temporary Work Shift Desired* Day Swing Night Any Shift Available Weekends #1 Previous Employment* Name of Employer Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code From: & To:*Salary*Duties and Responsibilities*Reason for Leaving*Supervisors Name*#2 Previous Employment* Name of Employer Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code From: & To:*Salary*Duties and Responsibilities*Reason for Leaving*Supervisors Name*NameThis field is for validation purposes and should be left unchanged.
