Employment Application Form Page 2
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1
2Employment History: (Start with your most recent employer and work back.)
Employer:
Start Date:
End Date:
⃞
Supervisor’s Name:
Phone #
May we contact?
Duties:
Reason for leaving?
Employer:
Start Date:
End Date:
⃞
Supervisor’s Name:
Phone #
May we contact?
Duties:
Reason for leaving?
Employer:
Start Date:
End Date:
Supervisor’s Name:
Phone #
⃞
May we contact?
Duties:
Reason for leaving?
Employer:
Start Date:
End Date:
Supervisor’s Name:
Phone #
⃞
May we contact?
Duties:
Reason for leaving?
List references below, if different from above.
If hired, on what date would you be available to start work?
By submitting this form, I declare that the above statements are true and give WynnWood Division of Canfor,
Permission to investigate all references and information given. I agree that any false statement or misrepresentation
on this application will be cause for refusal to hire or dismissal.
If requested, I agree to undergo a medical examination conducted by a Wynndel Box & Lumber Co Ltd. authorized
Physician. The results of which will not be cause for refusal to hire unless they directly indicate my inability, or
unsuitability, to carry out the duties of the job I am applying for.
Applicant Signature: ______________________________ .
Date: ________________________ .
Rev March, 2017
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Parent category: Business