CITY OF NANAIMO JOB APPLICATION FORM INSTRUCTIONS Please print off by richman10

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									CITY OF NANAIMO
JOB APPLICATION FORM
INSTRUCTIONS: Please print off this form, then complete all sections as thoroughly as possible, even if you are attaching a resume. This application will introduce us to your experience, education and skills. It is necessary to provide complete information, as it will be used to determine eligibility. Past work performance checks will be conducted prior to appointment. All information provided to us will be considered confidential in the competition process. Please submit a separate application for each position/competition. This application must be received at the Human Resources office by the date indicated in the advertisement. All candidates will be notified by mail of the competition outcome DATE RECEIVED

PERSONAL INFORMATION Last Name Street Province PHONE NUMBER Home May we contact you at work? SOCIAL INSURANCE NUMBER | | Yes | | | | Business No | Yes | | | No First Name City Postal Code Initial

Are you legally entitled to work in Canada?

EMPLOYMENT OBJECTIVES POSITION DESIRED: __________________________________________________________________ _____________________________________________________________________________________ Full Time

❏

Part Time

❏ Temporary

❏ Seasonal

Date available for work:

SKILLS/EXPERIENCE Check ( ) areas of skill/experience that you have which are relevant to the position you are applying for and attach any appropriate documentation. Net Speed Typing Dictating equipment Shorthand Word processing Data entry Computer system software Computer system hardware Trades: Heavy equipment operation experience: Other: Do you have a valid BC Driver’s Licence? Expiry Date: Air Brake Endorsement? EDUCATION/TRAINING Name Secondary/High School Yes No Yes No Class 1 2 3 4 5 Length of Experience List Equipment

Grade Level Degree/Diploma

Date Completed

Trade and/or Technical

University/College

Other (Courses/Certificates)

Special Qualifications (experience or training in the building or mechanical trades; certifications related to position applied for)

EMPLOYMENT HISTORY Start with your present or most recent employer and work back - please attach a copy of your resume if you wish to provide additional information. EMPLOYER Address Phone number Period Worked From: Month Job Title Job Duties Reference Contact: EMPLOYER Address Phone number Period Worked From: Month Job Title Job Duties Reference Contact: EMPLOYER Address Phone number Period Worked From: Month Job Title Job Duties Reference Contact: Phone Number: / Year Supervisor To: Month / Year Phone Number: / Year Supervisor To: Month / Year Phone Number: / Year Supervisor To: Month / Year

OTHER RELATED SKILLS, TRADES OR HOBBIES Please list hobbies, outside interests and activities that you enjoy doing in your spare time. List any clubs or associations and your involvement in them - i.e. executive, coach.

DECLARATION All the information that I have given in this application is true and correct. I understand that any false statement given could result in dismissal or prohibit employment. I further authorize my former employers and other individuals to give information concerning me and I release them and their companies from any liabilities.

SIGNATURE

DATE

The information on this form is collected under the program mandate for the Human Resources Department. The information provided will be used to process your application for employment. If you have any questions about the collection and use of this information, contact: J. McNeill, Director of Human Resources (250) 755-4427.


								
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