Application For Employment

The Human Rights Codes prohibit discrimination in employment because of race, national or ethnic origin, colour, religion, age, sex, marital status, family status, disability or conviction for an offense for which a pardon has been granted
 

Please provide the following contact information:
*The red fields must be filled for this request.

First name*
Last name*
Middle initial

Please provide the Present Address

Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Home Phone

Please provide the Permanent Address

Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Home Phone

Please provide the E-mail address

E-mail*

Specific Job(s) Applied For

1*

Rate of pay expected

per

2

Rate of Pay expected

per

How did you learn of an opening?


Availability:  *(INCLUDES WEEKENDS)

Anytime
Weekends Only
*Days
*Evenings  

Have you worked for us before?

Yes
No

If Yes, when?

-- mm/dd/yy

If hired, on what date will you be available to start work?

-- mm/dd/yy

Are you bondable?

Yes
No

Have you ever been convicted of a criminal offense for which you have not been pardoned?

Yes
No

Prior work history (list in order, last or present employer first)

Name
Title
Organization
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
From -- mm/dd/yy
To -- mm/dd/yy
Rate of Pay - Start
Finish
Reason for leaving
Job Description
Name
Title
Organization
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
From -- mm/dd/yy
To -- mm/dd/yy
Rate of pay - Start
Finish
Reason for leaving
Job Description
Name
Title
Organization
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
From -- mm/dd/yy
To -- mm/dd/yy
Rate of Pay - Start
Finish
Reason for leaving
Job Description

May we contact the employers listed?

Yes
No

If not, indicate below which one(s) you do not wish us to contact.

One    Two    Three  

Are there any other experiences, skills or qualifications which you feel would especially qualify you to work with us?


Educational Background

Secondary School

Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
From -- mm/dd/yy
To -- mm/dd/yy
Graduated Yes No
Course or Major

College

Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
From -- mm/dd/yy
To -- mm/dd/yy
Graduated Yes No
Course or Major

Post Graduate

Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
From -- mm/dd/yy
To -- mm/dd/yy
Graduated Yes No
Course or Major

Business or Trade

Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
From -- mm/dd/yy
To -- mm/dd/yy
Graduated Yes No
Course or Major

Other

Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
From -- mm/dd/yy
To -- mm/dd/yy
Graduated Yes No
Course or Major

 

Personal References

Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Home Phone
Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Home Phone
Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Home Phone
Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Home Phone
Thank you for completing this application form and for your interest in employment with us.  We would like to assure you that your opportunity for employment with this Company will be based only on your merit and on no other considerations.

 

PLEASE READ CAREFULLY APPLICANT'S CERTIFICATION AND AGREEMENT
I hereby certify that the facts set forth in this employment application are true and complete to the best of my knowledge.  I understand that if employed, falsified statements on this application shall be considered sufficient cause for dismissal.