Alberta Asphalt Enterprises Inc

ALBERTA ASPHALT ENTERPRISES INC. 6450 – 27 STREET N.W. EDMONTON, AB T6P 1M6 PHONE: (780) 469-9999 FAX: (780) 466-3952 Email: [email protected]

EMPLOYMENT APPLICATION APPLICANT INFORMATION

DATE: FULL NAME: LAST FIRST M.I.

ADDRESS: STREET ADDRESS APARTMENT/UNIT #

CITY PROVINCE POSTAL CODE PHONE: ( ) EMAIL ADDRESS:

DATE AVAILABLE: S.I.N. DESIRED RATE $

POSITION APPLIED FOR: YES NO ARE YOU A CANADIAN CITIZEN □ □ ARE YOU LEGALLY ABLE TO WORK IN CANADA □ □ HAVE YOU EVER BEEN CONVICTED OF A CRIMINAL OFFENCE □ □ IF YES, EXPLAIN EDUCATION HIGH SCHOOL: ADDRESS: YES NO FROM: TO DID YOU GRADUATE □ □

COLLEGE: ADDRESS: YES NO FROM: TO: DID YOU GRADUATE □ □

TRADE SCHOOL: ADDRESS: YES NO FROM: TO: DID YOU GRADUATE □ □ ALBERTA ASPHALT ENTERPRISES INC. 6450 – 27 STREET N.W. EDMONTON, AB T6P 1M6 PHONE: (780) 469-9999 FAX: (780) 466-3952 Email: [email protected]

REFERENCES PLEASE LIST THREE (3) REFERENCES (TWO MUST BE WORK)

FULL NAME: TITLE: COMPANY: PHONE: ADDRESS:

PREVIOUS EMPLOYMENT COMPANY: PHONE: ADDRESS: SUPERVISOR: JOB TITLE: STARTING $ ENDING $ SALARY SALARY FROM: TO: REASON FOR LEAVING: YES NO MAY WE CONTACT YOUR PREVIOUS EMPLOYER FOR A □ □ REFERENCE

COMPANY: PHONE: ADDRESS: SUPERVISOR: JOB TITLE: STARTING $ ENDING $ SALARY SALARY FROM: TO: REASON FOR LEAVING: YES NO MAY WE CONTACT YOUR PREVIOUS EMPLOYER FOR A □ □ REFERENCE

COMPANY: PHONE: ADDRESS: SUPERVISOR: JOB TITLE: STARTING $ ENDING $ SALARY SALARY FROM: TO: REASON FOR LEAVING: YES NO MAY WE CONTACT YOUR PREVIOUS EMPLOYER FOR A □ □ REFERENCE ALBERTA ASPHALT ENTERPRISES INC. 6450 – 27 STREET N.W. EDMONTON, AB T6P 1M6 PHONE: (780) 469-9999 FAX: (780) 466-3952 Email: [email protected]

DISCLAIMER AND SIGNATURE

I CERTIFY THAT MY ANSWERS ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

IF THIS APPLICATION LEADS TO EMPLOYMENT, I UNDERSTAND THAT FALSE OR MISLEADING INFORMATION IN MY APPLICATION OR INTERVIEW MAY RESULT IN MY RELEASE.

SIGNATURE OF APPLICANT: DATE:

AUTHORIZATION TO OBTAIN REPORTS

REPORTS SUCH AS MY DRIVING RECORD MAY BE NECESSARY TO EVALUATE MY APPLICATION FOR EMPLOYMENT.

BY SIGNING THIS AGREEMENT, I AUTHORIZE THE PROCUREMENT OF SUCH REPORTS AS NEEDED TO EVALUATE MY STATUS FOR EMPLOYMENT AND INSURABILITY.

SIGNATURE OF APPLICANT / EMPLOYEE

PRINT FULL NAME (CLEARLY

DRIVERS LICENSE #/PROVINCE EXPIRY DATE

PLEASE INCLUDE DRIVERS ABSTRACT WITH APPLICATION ALBERTA ASPHALT ENTERPRISES INC. 6450 – 27 STREET N.W. EDMONTON, AB T6P 1M6 PHONE: (780) 469-9999 FAX: (780) 466-3952 Email: [email protected]

ADDITIONAL INFORMATION

PLEASE USE THIS AREA TO INCLUDE ADDITIONAL INFORMATION ABOUT YOURSELF THAT WAS NOT COVERED IN PREVIOUS SECTIONS OF THIS APPLICATION THAT YOU FEEL WE, AS A POTENTIAL EMPLOYER, SHOULD KNOW ABOUT YOURSELF (EXAMPLE: CERTIFICATIONS; SKILLS; KNOWLEDGE; ETC.)

OFFICE USE AREA

INTERVIEW DATE: TIME: NAME/S FOR WHAT POSITION

ADDITIONAL INFORMATION REQUIRED: