Application for Employment

Qualified applicants are considered for all positions without regard to race, color, religion, national origin, age, marital or veteran status, or presence of a non-job-related medical condition or handicap. It is unlawful in Massachusetts, Connecticut & New Jersey to require or administer a lie detector test as a condition of employment or continued employment. An employee who violates this law shall be subject to criminal penalties and civil liability.

Last Name*

First Name*

Middle Name

Present Street Address*

City*

State*

Zip*

Phone*

Cell Phone*

Email*

Are you over 18 years old?*

YesNo

Are you legally authorized to work for any US employer?*

YesNo

Do you now or will you in the future require sponsorship for a work visa?*

YesNo

Have you worked here before?*

YesNo

How did you hear about this position?*

Are there any hours, shifts, or days you cannot or will not work?*

List friends or relatives working here:*

Education / Experience

High School or GED School Name & Location:

Number of Years Completed
Diploma / Degree / Certificate
Subjects Studied

Vocational or Technical:

Number of Years Completed
Diploma / Degree / Certificate
Subjects Studied

College or University:

Number of Years Completed
Diploma / Degree / Certificate
Subjects Studied

College or University:

Number of Years Completed
Diploma / Degree / Certificate
Subjects Studied

In addition or your work experience, what skills or additional training do you have that relate to the job for which you are applying?

What machines or equipment can you operate?

Languages Spoken?*

Military Service Record

Have you ever served in the U.S. Armed Forces?*

YesNo

Dates of Duty*toDates of Duty

Applicable skills acquired:

Position(s) Applied For

Position 1*

Position 2

Wage or salary desired?*

When can you start?

Previous Employment History

List names of employers in consecutive order with present or last employer listed first. You may include as part of your work history any verified work performed on a volunteer basis.

Name of Employer*
Address*

City*
State*
Zip*

Phone*
Title*
Duties*

Supervisor's Name*
Supervisor's Title*

Start Date*
End Date

Supervisor's Email*
Reason for Leaving*

May we contact?*

YesNo

Name of Employer
Address

City
State
Zip

Phone
Title
Duties

Supervisor's Name
Supervisor's Title

Start Date
End Date

Supervisor's Email
Reason for Leaving

May we contact?

YesNo

Name of Employer
Address

City
State
Zip

Phone
Title
Duties

Supervisor's Name
Supervisor's Title

Start Date
End Date

Supervisor's Email
Reason for Leaving

May we contact?

YesNo

Name of Employer
Address

City
State
Zip

Phone
Title
Duties

Supervisor's Name
Supervisor's Title

Start Date
End Date

Supervisor's Email
Reason for Leaving

May we contact?

YesNo

Name of Employer
Address

City
State
Zip

Phone
Title
Duties

Supervisor's Name
Supervisor's Title

Start Date
End Date

Supervisor's Email
Reason for Leaving

May we contact?

YesNo

Applicant's Certification and Agreement

I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for is cause for dismissal. I understand, also, that I am required to abide by all rules and regulations of Rex Lumber Company. Further, I understand and agree that my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without any previous notice.

First and Last Name*

Date

Signature*

Pre-Employment Company Physical and Drug Test

Rex Lumber Company is committed to providing a safe, healthy and productive work environment. In this regard, our offer of employment is contingent upon your meeting the medical requirements as determined by pre-employment physical examination, which will include a drug test. Should you fail to pass the physical examination, including the drug test, our offer of employment will be withdrawn.

First and Last Name*

Date

Application for Employment

Education / Experience

Military Service Record

Position(s) Applied For

Previous Employment History

Applicant's Certification and Agreement

Pre-Employment Company Physical and Drug Test

Current Job Openings