Form Hr-001fr - Employment Application printable pdf download

EMPLOYMENT APPLICATION

Date:

Date available to begin work:

Employment Desired:

Part-Time

Full-Time

Position being applied for:

Preferred Location (1

Choice):

Preferred Location (2

Choice):

Personal Information

Last Name

First Name

Initial

Street Address

Apt. No.

City

Province

Postal Code

Home Telephone No.

Work Telephone No.

(

)

(

)

Ext.

Are you legally eligible to work in Canada?

Yes/No

Have you ever been convicted of a criminal offence involving theft, fraud or other similar offences for which you have not been pardoned?

Yes/No

If applicable, are you eligible to serve liquor in the province that you are applying to work in?

Yes/No

(British Columbia, Saskatchewan, Nova Scotia, NFLD & Labrador, PEI, New Brunswick, Inuvik– 19 years old, Alberta, Manitoba, Ontario, Quebec – 18 years

old)

Have you ever been employed at a Pizza Hut, KFC, Taco Bell restaurant?

Yes/No

If yes, where? ___________________________________________ Date of Employment From: ______________________To: _____________________

Who was your Manager?

Hours Available

Mon

Tues

Wed

Thurs

Fri

Sat

Sun

From:

To:

Education

Name

Levels of

No. of Years

Did you

Degree Received

of Program

Completion

Attended

graduate?

Employment

Company:

Address:

Name of Supervisor:

Position/Duties Performed:

Reason for Leaving:

Employed From:

To:

Phone No. (

)

Starting Pay: $

Ending Pay: $

Company:

Address:

Name of Supervisor:

Position/Duties Performed:

Reason for Leaving:

Employed From:

To:

Phone No. (

)

Starting Pay: $

Ending Pay: $

Personal References (not former employers or relatives, exclude Ministers of religion)

Name:

Relationship or Title:

Phone No. (

)

Name:

Relationship or Title:

Phone No. (

)

Signature

I certify that the above information is correct and understand that falsification is grounds for termination with cause. I authorise the references, supervisors,

and educational institutions listed above to give you any information concerning my prior employment or education. I understand that you, as my potential

employer, are collecting my personal information on this form and from the references, supervisors and educational institutions listed above to determine my

suitability for the position I have applied for and, if I am hired, for the purpose of our employment relationship. I understand and agree that you, as my

potential employer, will use and disclose my personal information only for those purposes or as permitted or required by law. By signing this form, I consent

to the collection, use and disclosure by you, as my potential employer, of my personal information for these purposes.

Name:______________________________________

Signature:_______________________________________

Date:________________________

FILL OUT BELOW AT TIME OF HIRE ONLY

Social Insurance No.

Sex:

Legal Marital Status:

Birthdate:

Language:

Proficiency Level:

Single