The Pickle Station - Cucumber Sorting Application 23955 Prince Albert Road, Chatham, ON, N7M 5J1 For July-August 2012 Season APPLICANT INFORMATION Last Name First Date Street Address Apartment/P.O. # Postal City Province Code E-mail Phone Address Are you able to work all Date Available YES NO If no, explain days of the week? How many hours would you like to work each week? How many days would you like to work each week? Will you be at least 14 years old in July YES NO Are you prone to motion sickness? YES NO If so, Have you ever worked for this company? YES NO when? If yes, Have you worked on a conveyor line? YES NO explain EDUCATION Elementary NO From (Years) To Did you graduate? YES High School NO From To Did you graduate? YES College/University NO From To Did you graduate? YES Degree REFERENCES Please list one reference. Full Name Relationship Company Phone ( ) PREVIOUS EMPLOYMENT Company Phone ( ) Job Title Responsibilities Reason for From To Leaving Please email completed application to firstname.lastname@example.org or fax to (519) 352-4280 Thank you for your application.
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