APPLICATION FOR EMPLOYMENT

Date:		Position Applied for:
Wage Expected:		Date Available:
Name:
Phone:		Social Insurance Number:
Address:			BC AB MB NB NL NT NS NU ON PE QC SK YT
Email Address:
Are you legally eligible to work in Canada?	Yes No

EDUCATION RECORD

	School Name / Address	From	To	Major Subject	Diploma / Degree Awarded
Secondary School:					Yes No Title:
Business, Trade or Technical School:					Yes No Title:
Community College:					Yes No Title:
University:					Yes No Title:

Additional Courses, Seminars, Workshops:

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

English: Yes No French: Yes No Other: Yes No

EMPLOYMENT RECORD (Most Recent Employer first)

Company Name:		Employed from: To: Type of Business: Supervisor:	Present/Last Job Title:
Address:			Duties/Responsibilities:
Reason for Leaving:

Company Name:		Employed From: To: Type of Business: Supervisor:	Present/Last Job Title:
Address:			Duties/Responsibilities:
Reason for Leaving:

Company Name:		Employed from: To: Type of Business: Supervisor:	Present/Last Job Title:
Address:			Duties/Responsibilities:
Reason for Leaving:

Have you ever been employed by this company before? Yes No If yes:	What source referred you to this company?
What was your position when you left?	Are you willing to work shift work? Yes No
May we contact your present employer? Yes No	Are you willing to relocate? Answer only if job related Yes No	Preferred locations:

Outside hobbies and interests, service clubs or professional associations: do not list clubs or organizations of a religious, racial, political or national character:

REFERENCES

List two persons to whom we may refer (not relatives or previous employers)
Name:		Address:
Occupation:		Telephone:
Name:		Address:
Occupation:		Telephone:

I hereby declare that the foregoing information is true and complete to my knowledge. I understand that a false statement may disqualify me from employment or cause my dismissal. I further understand that if this position requires a valid drivers licence, proof thereof will be required after hire.

Agree Disagree