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#CBT-9343-069065
Supplemental Questionnaire

Last Name
First Name

 

9343 Roofer CBT-9343-069065
SUPPLEMENTAL APPLICATION

INSTRUCTIONS: This supplemental questionnaire will be used to assess possession of the minimum qualifications of the 9343 Roofer for which you are applying. This supplemental application MUST be must be included in your employment record/application and submitted with the official application at the time of filing.

ALL RESPONSES MUST BE INCLUDED IN THIS SUPPLEMENTAL APPLICATION. SUPPORTING DOCUMENTATION (SUCH AS LICENSES, RESUMES, ETC.) WILL NOT SUBSTITUTE FOR THIS SUPPLEMENTAL APPLICATION.
1

I have completed a Roofer apprenticeship program recognized by the State of California:
Yes No
2

I possess the following number of years as a journey-level roofer or equivalent experience:
I do not have any experience in these areas
Less than 1 year of experience
At least 1 years but less than 2 years
At least 2 years but less than 3 years
At least 3 years but less than 4 years
At least 4 years but less than 5 years
At least 5 years but less than 6 years
At least 6 years but less than 7 years
I have over 7 years of experience
2a

Please provide your job title(s), employers, dates of employment, and the contact person(s) with his/her working title and phone number who can verify the journey-level roofer or equivalent experience provided above. If you have indicated that you do not possess experience in these areas enter "N/A".
3

I am able to lift and carry materials weighing up to 110 pounds for distances up to 100 feet:
Yes No
4

I possess a valid Driver License (California DMV Class “C” or above):
Yes No
5

I understand and agree to provide verification of education, training, and/or experience, mentioned above, when requested.
Yes No
 

Certification:
I hereby certify that I am the author of this questionnaire and that all information is true based on my education, training, skills, and/or experience. I understand that any false or incorrect statement may result in my disqualification from this exam and/or dismissal from employment with the City and County of San Francisco. I also understand and agree to provide verification, when requested.