| Personal Information |
|
|
* required fields |
|
| Name |
|
|
| Street Address |
|
|
| Address (cont.) |
|
|
| City |
|
|
| Postal Code |
|
|
| Province |
|
|
| Work Phone |
|
|
| Home Phone |
|
|
| Are you 18 years or older? |
|
|
| E-mail |
|
|
| Position Desired |
|
|
| Position applying for |
|
|
| Date you can start |
|
|
| Desired Salary |
|
|
| Are you currently employed? |
|
|
| If yes, may we inquire of your present employer? |
|
|
| Employment History (three most recent) |
| Company |
|
|
| Position |
|
|
| Dates Employed |
|
| From |
|
|
| To |
|
|
| Salary |
|
|
| Reason for leaving |
|
|
| Company |
|
|
| Position |
|
|
| Dates Employed |
|
| From |
|
|
| To |
|
|
| Salary |
|
|
| Reason for leaving |
|
|
| Company |
|
|
| Position |
|
|
| Dates Employed |
|
| From |
|
|
| To |
|
|
| Salary |
|
|
| Reason for leaving |
|
|
| Briefly describe your job related skills |
|
|
| Please list up to 3 references |
| Name |
|
|
| Telephone (include area code) |
|
|
| Years known |
|
|
| Name |
|
|
| Telephone (include area code) |
|
|
| Years known |
|
|
| Name |
|
|
| Telephone (include area code) |
|
|
| Years known |
|
|
| Education |
| School |
|
|
| Degree |
|
|
| Date of Graduation |
|
|
| Course of special study or research work |
|
|
| Word Verification |
|
* 
|
| AUTHORIZATION |
|
| I certify that the facts contained in this application (and accompanying resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application is sufficient cause for refusal to hire or dismissal if I have been employed no matter when discovered by the Company. |
|
| I understand that any employment is conditioned on a background check. I authorize the Company to thoroughly investigate all statements contained in my application or resume, and I authorize any former employers and references to disclose information regarding my former employment, character and general reputation of the Company, without giving me prior notice of such disclosure. In addition, I release the Company, and former employers and all references listed above from any all claims, demands or liabilities arising out of or related to such investigation or disclosure. |
|
| I understand and agree that nothing contained in this application, or conveyed during any interview is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be "at will" and without fixed term, and may be terminated at any time, with or without cause and without prior notice, at the option of either myself or the Company. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the Company unless made in writing. |
|
| I understand that filling out this form does not indicate there is a position open and does not obligate the Company to hire. If hired, I agree to abide by all Company work rules, policies and procedures. The Company retains the right to revise its policies or procedures, in whole or in part at any time. |
|
