Canada Sample Job Application

APPLICATION

EMPLOYMENT

Style Encore Winnipeg East B-1094 Nairn Ave Winnipeg, MB R2L 0Y4 www.style-encorewinnipegeast.com [email protected]

We at Style Encore are committed to a policy of equal treatment and opportunity in every aspect of our employment relations without regard to race, ancestry, place of origin, ethnic origin, colour, citizenship, creed, sex, sexual orientation, age, marital status, family status, disability, or any other legally protected class status. This includes, but is not limited to, recruiting, hiring selection for training, transfers, promotion, compensation, and any company sponsored social and recreational programs. PLEASE PRINT

Name ______Date ______

Present Address ______Address City Province Postal Code

Email Address (optional) SIN # (optional) ______Telephone (___) ______

Referred by ___ Advertisement ___ Agency ___ Person ___ Other ______

Are you legally entitled to employment in Canada? ___ Yes ___ No Are you between 18 and 65? ______If under 18, please state your age: ______

Position applying for ______Salary expected ______

Are you available to work ___ Full-time ___ Part-Time Specify schedule limitations ______

Date available for work ______List friends or relatives in our employ ______

Were you previously employed by us? ___ Yes __ No If yes, when ______

Other name(s) used while attending schools or places of employment indicated on this form ______

Can you perform the primary functions of this job with or without reasonable accommodation? __ Yes __ No

Have you ever been convicted of a criminal offence for which a pardon has not been granted? __ Yes __ No If yes, please explain: (Note - a conviction alone will not automatically bar you from employment.) ______

Military Service? __ Yes __ No Branch of Service and Rank ______Dates of Service______Special Training ______EDUCATION

Course Scholastic Dates of Graduated of Study Average Attendance Name and Location Yes/No Mo/Year Degree High School/GED N/A N/A College

Vocational

Additional comments regarding education ______

______

______SKILLS List Computer Software Packages in which you are proficient ______What languages do you:

______speak fluently ______

Point of Sale System (cash register)______write fluently ______

Other Skills ______read fluently ______

EMPLOYMENT HISTORY (List present or most recent employer first) Name of Company ______Address ______

Supervisor ______Salary ______Phone ______

Job Title ______Date Started ______Date Left ______

Job Description ______

______Reason for Leaving:

Name of Company ______Address ______

______Reason for Leaving: AUTHORIZATION FOR BACKGROUND CHECK: I authorize [insert name of employer] to verify employment, except as noted below, as well as conduct criminal and vehicular record check.

Indicate those you do not wish contacted:______

Signed: ______Date: ______REFERENCES Please list three persons other than relatives or personal friends, who can judge your work ability.

1) Name ______Occupation ______

Address ______Phone ______

Please use the space provided below to summarize any additional information necessary to fully describe your qualifications.

______

*** PLEASE READ ***

All information written on this application is complete and accurate to the best of my knowledge. I understand that any misrepresentation of facts in this application disqualifies me from further consideration - or if employed - is grounds for dismissal. I understand that any employment offer is contingent upon satisfactory references and I authorize [insert name of employer] to investigate past employment and education history, as well as references.

I fully understand and agree to all statements above.

______Signature Date

OFFICE USE ONLY

Interviewed by ______Date ______

Referral Source ______Hired ______Not Hired ______

Starting Date ______Position ______Salary ______

Location ______Reporting To ______