Position Applied For* :
Full Time/Part Time?
Full Time
Part Time
Expected Salary:
Available Start Date* :
(month/day/year)
PERSONAL INFORMATION
Full Name* :
Address:
City:
Province/State:
Country:
Postal/Zip Code:
E-mail Address:
Telephone* :
Do you have any physical limitation that would affect your ability to do heavy lifting?
Yes
No
If Yes, please explain:
We run a 24-hour operation from Monday through Friday. We require all employees to be available for at least 2 out of the 3 shifts. What shifts are you available for?
(please check all that apply)
Days (6am – 2:30pm)
Afternoons (2:30pm – 11pm)
Graveyards (10:30pm – 7am)
Have you been convicted of any criminal or summary offence for which no pardon has been granted?
Yes
No
GENERAL INFORMATION
Do you speak English?
Yes
No
Can you write English?
Yes
No
Can you read English?
Yes
No
Do you have a valid drivers license?
Yes
No
Do you have access to a vehicle to get to and from work?
Yes
No
EDUCATION AND TRAINING
EMPLOYMENT EXPERIENCE
(Please list your present or most recent employer first)
Employer Name:
Address:
City:
Province/State:
Country:
Position Held:
Salary:
Supervisor's Name & Title:
Dates Employed:
From (month/year):
To (month/year):
Reason for Leaving:
Duties Performed:
Employer Name:
Address:
City:
Province/State:
Country:
Position Held:
Salary:
Supervisor's Name & Title:
Dates Employed:
From (month/year):
To (month/year):
Reason for Leaving:
Duties Performed:
REFERENCES
Applicants are requested to supply below the names of three persons whom they have known for at least two years and who can, if necessary, be contacted at our discretion for references. In the case of applicants for technical vacancies, two of the references should be able to vouch for the technical ability of the applicant.
Has any employee of Corporate Images referred you to us?
Yes
No
If Yes, Name of Person:
By submitting this application, you acknowledge that the information provided in this application is complete and accurate to the best of your knowledge, you also acknowledge that falsification and/or incomplete information may jeopardize your employment with Corporate Images now or in the future.
By submitting this application, you agree to abide by all present rules and regulations of the Company and you further agree to abide by future rules and regulations that may be instituted by the Company.
By submitting this application, you are consenting on your behalf to the collection, use, and disclosure of your personal information for purposes reasonably associated with your employment.
Application forms for unsuccessful candidates will be kept on file for six months.