Employment Application

Applicant Information

Name*

First Middle Last

Address*

Street Address Address Line 2 City Province Postal Code

Phone*

Email*

Date Available:*

Social Security No.:*

Desired Salary:$*

Position Applied for:*

Are you a Canadian citizen?

Yes

If no, are you authorized to work in Canada?

Yes

Have you ever worked for this company?

Yes

If yes, when?

Have you ever been criminally charged?

Yes

If yes, explain:

Education

High School:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

From:

To:

Did you graduate?

Yes

Diploma

College:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

From:

To:

Did you graduate?

Yes

Diploma

Other:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

From:

To:

Did you graduate?

Yes

Diploma

References

Please list three professional references.

Name

First Last

Relationship:

Company:

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name

First Last

Relationship:

Company:

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name

First Last

Relationship:

Company:

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Previous Employment

Company:

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisor:

Job Title:

Starting Salary:$

Ending Salary:$

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?

Yes

Section Break

Company:

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisor:

Job Title:

Starting Salary:$

Ending Salary:$

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?

Yes

Section Break

Company:

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisor:

Job Title:

Starting Salary:$

Ending Salary:$

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?

Yes

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