<p> ● IQALUIT FIRE DEPARTMENT ● CITY OF IQALUIT – APPLICATION FOR EMPLOYMENT</p><p>POSITION FIREFIGHTER VOLUNTEER DESIRED MEDICAL SERVICES FULL-TIME DISPATCH CASUAL</p><p>APPLICANT’S SURNAME GIVEN NAMES</p><p>ADDRESS:</p><p>POSTAL CODE: HOME TELEPHONE: OTHER TELEPHONE:</p><p>( ) ( ) ARE YOU LEGALLY HAVE YOU EVER BEEN FROM TO ENTITLED TO WORK YES EMPOLYED BY THE YES CITY OF IQALUIT NO ______IN CANADA NO IF “YES” WHAT DEPT ? MM YY MMYY HAVE YOU PREVIOUSLY APPLIED FOR A POSITION WITH THE IQALUIT FIRE DEPARTMENT YES NO</p><p>IF YES, WHEN? ______</p><p>EMPLOYMENT (Beginning with your present employer – list all jobs including part-time HISTORY positions) COMPANY NAME: PRESENT/LAST POSITION</p><p>ADDRESS NAME OF SUPERVISIOR SUPERVISIOR NUMBER 1. CITY PROV POSTAL PERIOD OF EMPLOYMENT ______TO ______MM YY MM YY TYPE OF BUSINESS REASON FOR LEAVING</p><p>COMPANY NAME: PRESENT/ LAST POSITION:</p><p>ADDRESS: NAME OF SUPERVISIOR SUPERVISIOR NUMBER</p><p>CITY PROV POSTAL PERIOD OF 2. EMPLOYMENT ______TO ______MM YY MM YY</p><p>TYPE OF BUSINESS: REASON FOR LEAVING: ● IQALUIT FIRE DEPARTMENT ● CITY OF IQALUIT – APPLICATION FOR EMPLOYMENT PAGE 2 COMPANY NAME PRESENT/LAST POSITION</p><p>ADDRESS NAME OF SUPERVISIOR SUPERVISIOR NUMBER</p><p>CITY PROV POSTAL PERIOD OF 3. EMPLOYMENT ______TO ______MM YY MM YY TYPE OF BUSINESS REASON FOR LEAVING</p><p>PERSONAL DATE OF BIRTH SOCIAL DRIVER’S CLASS PROV INSURANCE LICENCE INFORMATION NUMBER ______19__ EDUCATION ELEMENTARY/SECONDARY: CIRCLE THE HIGHEST YEAR SUCCESSFULLY COMPLETE: 1 2 3 4 5 6 7 8 9 10 11 12 13 INDICATE MAJOR SUBJECT OR SPECIALIZATION: TYPES OF SCHOOL TYPE OF YEARS DIPLOMA/ PROGRAMS COMPLETE CERTIFICATE OBTAINED SECONDARY UNIVERSITY OTHER(TRADE, NIGHSCHOOL, ETC.) ARE YOU CURRENTLY ENROLLED IN ANY COURSES? YES NO DO YOU HAVE A VALID FIRST AID CERTIFICATE? YES NO DO YOU HAVE A VALID CPR CERTIFICATE? YES NO DO YOU HAVE ANY OTHER CERTIFICATION, SKILLS OR EXPERIENCE THAT PERTAINS TO THE FIELD OF EMERGENCY SERVICES? PLEASE LIST BELOW</p><p>REFERENCES NAME: NAME: ADDRESS: ADDRESS: PHONE NUMBER: PHONE NUMBER:</p><p>I affirm that all information given herein is true and correct I hereby authorize the investigation of all statements made herein in and understand that any misrepresentation or falsehood is cause for dismissal.</p><p>______/20_____ SIGNATURE DATE</p><p>* Please note: Resume and application must me submitted together with a criminal records check </p>
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