Application for Employment 2012
Position Applied for: (*)
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Preferred Location: (*)
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Personal Data
Surname: (*)
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First Name: (*)
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Middle Name: (*)
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Street Address: (*)
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City: (*)
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Province: (*)
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Postal Code: (*)
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Home Phone: (*)
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Cell Phone:
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Work Phone:
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Email: (*)
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Education and Training
High School/GED
Name of Institute:
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Location of Institute:
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Grade/Diploma/Degree Completed:
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Year Completed:
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Commercial, Trade, or Technical Training
Name of Institute:
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Location of Institute:
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Grade/Diploma/Degree Completed:
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Year Completed:
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College/University
Name of Institute:
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Location of Institute:
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Grade/Diploma/Degree Completed:
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Year Completed:
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Other Continuing Education
Name of Institute:
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Location of Institute:
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Grade/Diploma/Degree Completed:
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Year Completed:
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Professional Qualifications/ Memberships/ Licenses
if applicable:
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*Copies of most relevant education certificates
are required
If applying for a position requiring a driver's
license, please complete the following:
Do you have a valid driver's license?
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Class:
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Province
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Employment History(begin with most recent)
Company Name:
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Company Address:
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Company Phone:
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Immediate Supervisor:
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Position:
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Job Duties:
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Worked From:
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To:
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Reason for Leaving:
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Company Name:
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Company Address:
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Company Phone:
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Immediate Supervisor:
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Position:
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Job Duties:
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Worked From:
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To:
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Reason for Leaving:
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Company Name:
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Company Address:
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Company Phone:
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Immediate Supervisor:
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Position:
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Job Duties:
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Worked From:
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To:
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Reason for Leaving:
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Employment References(three)
Name:
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Address:
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Telephone:
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Years Known:
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Position or Occupation:
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Name:
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Address:
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Telephone:
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Years Known:
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Position or Occupation:
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Name:
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Address:
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Telephone:
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Years Known:
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Position or Occupation:
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May we contact your present employer? (*)
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May we contact your past employers? (*)
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If no, please state reason:
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Criminal Records Search
Have you ever been convicted of an offense or do
you currently have any charges pending under The
Criminal Code of Canada, The Narcotics Control
Act, or The Food and Drugs Act?
Select an Option:
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If Yes, please indicate the nature of the
offence(s), the date(s) and place(s), and the
sentences imposed (if applicable).
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If offered a position, I will at my own expense
provide the results of a criminal records search by
the RCMP or City Police.
Employment shall be contingent upon receipt of the
criminal record check that is satisfactory to the SCSA.
Declaration
It is understood and agreed that the SCSA may at
any time seek verification of the above and further
information in considering my suitability for a position
at the SCSA. I hereby request and authorize anyone
approached by the SCSA, its employees and agents,
and anyone providing information pursuant
to a request from the SCSA to provide information
about me, from any and all claims whatsoever
which may arise as a result of the release of such information.
I understand and agree that any omission, false or
misleading statement may disqualify me from
employment or a dismissal. A photographic copy of
this authorization shall be valid as the
original.
I agree/disagree: (*)
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Upload Resume (*)
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Upload Cover Letter (*)
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Submit Form
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