JOB APPLICATION

First Name:

Last Name:

Telephone:

Work phone:

Street Address:

Apt. # :

City:

Province:

Postal Code:

Are you legally eligible to work in Canada:
YesNo

Social Ins. No. :

EDUCATIONAL BACKGROUND

High School:

Graduated:

YesNo

Length of Course:

Diploma Degree. License:

Community College:

Graduated:

YesNo

Length of Course:

Diploma Degree. License:

Trade or Business School:

Graduated:

YesNo

Length of Course:

Diploma Degree. License:

University:

Graduated:

YesNo

Length of Course:

Diploma Degree. License:

EMPLOYMENT (Names: present employer first)

Company Name:

Address:

Position:

Supervisor:

Employed From:

To:

Salary from:

To:

Reason for Leaving:

Company Name:

Address:

Position:

Supervisor:

Employed From:

To:

Salary from:

To:

Reason for Leaving:

Company Name:

Address:

Position:

Supervisor:

Employed From:

To:

Salary from:

To:

Reason for Leaving:

May we contact the employers listed above:

REFERENCES

Name:

Address:

Telephone:

Occupation:

Years Known:

Name:

Address:

Telephone:

Occupation:

Years Known:

Name:

Address:

Telephone:

Occupation:

Years Known:

GENERAL INFORMATION

Do you have a criminal record for which you have not received a pardon:

What machines do you operate competently:

What special qualifications do you have:

Describe any of your work-related skills, experience, or training that relate to the position being applied for.:

Do you want to work:

Do you have any friends or relatives working for the company:

Will you work shift work:

Date available to begin work:

Position being applied for:

PLEASE READ CAREFULLY

I authorize investigation of all statements contained in this application and I hereby certify that, to the best of my knowledge and belief, the answers given by me and the statements made are correct. I understand that any false information or consequential omission is cause for immediate dismissal.

Do not answer any questions that may, in your opinion infringe on your human rights.