W.O. STINSON & SON APPLICATION FOR EMPLOYMENT

Date of Application: (yyyy/mm/dd)
*Date Available to Start: (yyyy/mm/dd)
How did you hear of this opportunity?
If you were referred, please give the name of the employee that referred you:

MY AVAILABILITY & JOB POSITION (PLEASE CHECK ALL THAT APPLY)

POSITION




STATUS


Pay Expectations:
HOURS OF AVAILABILITY
  Mon Tue Wed Thu Fri Sat Sun
From
To

MY PERSONAL INFORMATION

* First Name:
* Last Name:
* Street Address:
* City:
* Province
* Postal Code:
* Home Phone #:
Cell Phone #:
Email:
* Are you legally eligible to work in Canada?

MY EMPLOYMENT HISTORY

Current / Most Recent Employer
* Can we contact this company?
* Company:
* Supervisor:
* Phone Number:
* Position / Duties:
* Reason for leaving:
Starting Pay:
Ending Pay:
Previous Employer
* Can we contact this company?
* Company:
* Supervisor:
* Phone Number:
* Position / Duties:
* Reason for leaving:
Starting Pay:
Ending Pay:

Have you ever worked at a W.O. Stinson's before?
If so, which location?
Store #:
Why did you leave?

EDUCATION AND ACTIVITIES

Please specify level of education completed:
What hobbies and / or activities are you involved in?

REFERENCES

List any references not listed above. Please do not list relatives.
NAME OCCUPATION RELATIONSHIP PHONE NUMBER

Please exclude any reference to any organization which could indicate race, religion, marital status, age, colour, gender, ancestry, political beliefs, sexual orientation, place of origin, physical disability, mental disability, or handicap.

The undersigned acknowledges that the foregoing statements and information fully and truthfully set forth the true and accurate personal information of the applicant as of the date hereof. The undersigned further acknowledges that for the purposes of determining and suitability of the undersigned for the position applied for, an investigation may be made with respect to relevant information. The undersigned hereby consents to collecting and retaining such information and conducting further investigations with respect to relevant information. The undersigned further consents to the updating of this information from time to time, as necessary.

SIGNATURE
DATE