EMPLOYEE INFORMATION - DOC by HC120808035840

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									                                                   Application for Employment
                                       Position being applied for:                       Date available to begin work:




                                                          Personal Data
Last Name                        Given Name(s)                                                                Social Insurance Number

Address: Apt. No.                Street                                                                       Home Telephone No.

City                             Province                     Postal Code                                     Business Telephone No.

Are you legally eligible to work in Canada?
                                                        Yes  No                Are you willing to re-locate?
                                                                                                                         Yes  No
Are you between 18 and 65 years of age?
                                                        Yes  No
Preferred Location                                                               Salary Expectation

                                 Name                                                                         Relationship
PERSON TO BE
NOTIFIED                         Address                                                                      Home Telephone No
IN CASE OF
EMERGENCY                                                                                                     Business Telephone No

To determine your qualification for employment, please provide below and on the reverse, information related to your academic and other
achievements, including voluntary work, as well as employment history. Additional information may be attached on a separate sheet.



                                                              Education
Secondary School                 Business, Trade or Technical School     College or University         Other courses, workshops, seminars


Name of Institution              Name of Institution                     Name of Institution           Licenses, Certificates, Degrees


Highest Level Completed          Name of Program        Course           Major Subject                 Work Related Skills
                                                        Length

Type of certificate or Diploma   License, Certificate or Diploma         Degree Awarded
Awarded                          Awarded

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




Have you been referred to us?
                                        Yes  No                  If yes, by whom?

Have you attached an additional sheet or resume to this form?
                                                                                                Yes           No
Office Use Only



       Revised: July, 2003
                                         Employment History
Name and Address of Present/Last Employer                                   Present/Last Job Title

                                                                            Period of Employment        Salary
                                                                            From           To
                                                                            Supervisor’s Name           Telephone

Type of Business                                                            Reason for Leaving

Duties/Responsibilities

Name and Address of Previous Employer                                       Present/Last Job Title

                                                                            Period of Employment        Salary
                                                                            From           To
                                                                            Supervisor’s Name           Telephone

Type of Business                                                            Reason for Leaving

Duties/Responsibilities

Name and Address of Previous Employer                                       Present/Last Job Title

                                                                            Period of Employment        Salary
                                                                            From           To
                                                                            Supervisor’s Name           Telephone

Type of Business                                                            Reason for Leaving

Duties/Responsibilities

For Employment References, may we contact:
Your Present/Last Employer?                         Yes  No               Your Previous
                                                                            Employers?                Yes        No

                                         Personal References
                                              Do no list ministers of religion
Name, Address & Telephone                                                   Known for how long?

                                                                            Relationship to you?

Name, Address & Telephone                                                   Known for how long?

                                                                            Relationship to you?

What else would you like us to know about you?


Do you have any relatives employed by this company?                         If yes, Name:        Location:
 Yes                       No
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.                        Signature                    Date




     Revised: July, 2003

								
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