Job Seekers ACTIVE EMPLOYMENT Application No. PERSONAL INFORMATION Gender MaleFemale Date Applied First Name (required) Last Name (required) Street Address (required) City (required) Province (required) Postal Code (required) D.O.B (required) Social Insurance Number WorkPermit Expiry Date Telphone no. Cell number Other Contact Number Are you legally entitled to work in Canada? YesNo Status in Canada CitizenPermanent ResidentRefugee ClaimStudentOthers HAVE YOUR EVER BEEN CONVICTED OF A CRIME? YesNo If yes, explain number of convictions(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation. Position Applied (Be Specific) Expected wages: ($/hr) How many hours can you work weekly? Can you work night? Employment Desired Full-TimePart-TimeWeekend Availability DaysAfternoonsMidnight Type of Work Desired: SelectGeneral LaborAssemblyWarehouseWeldingGrinderExtrusionMaterial HandlerSpray PaintOrder PickerGeneral OfficeAdmin/OfficeOther Forklift Operator SelectLicense TypeCounter BalanceReach TruckOther Trucks Forklift License Number Expiry Date Experience (years/month) When you are available for wok? WHAT TYPE OF GOVERNMENT ISSUED PHOTO ID YOU POSSESS: DRIVER LICENSECITIZENSHIP CARDHEALTH CARDPASSPORT ID Number Expiry Date What is your mean of transportation to work? Own CarPublic Transportation ACTIVE EMPLOYMENT High School (School Name) Location Number of years Completed Major Degree College (College Name) Location Number of years Completed Major Degree References (Provide two references) Reference 1 Full Name Position Company Name Phone Address Reference 2 Full Name Position Company Name Phone Address Employment History Company Name Employment Date From Employment Date To Last Pay Phone Address Supervisor Name Supervisor Phone Job Tittle Job Description Reason for Leaving May we Contact your present employer? SelectYesNo Did you complete this application yourself? SelectYesNo Print Full Name Signature Date Government Issued Photo ID Government Issued ID
