Your Name
Date
Your Present Address
Your Previous Address
(if less than 2 years)
Phone Number
SIN #
What kind of work are you best suited for?
What date are you available for work?
Summer only?
EDUCATION
Grade School (school name, grade completed,
age you left, what courses)
High School (school name, grade completed,
age you left, what courses)
University (school name, grade completed,
age you left, what courses)
Business School (school name, grade completed,
age you left, what courses)
PERSONAL HEALTH
Can you perform the essential duties
of the work you are applying for?
If not, why?
WORK REFERENCES
Reference 1 (name, address, occupation, phone)
Reference 2 (name, address, occupation, phone)
PREVIOUS EMPLOYMENT
1. Name of firm last employed at
What is the firm's business?
Address
Phone
What kind of work did you do?
Date employed
Date you left
Salary Range
Manager's Name
Why did you leave?
2. Name of previous employer
What is the firm's business?
Address
Phone
What kind of work did you do?
Date employed
Date you left
Salary Range
Manager's Name
Why did you leave?
Additional Comments
Employment by this company commences with a 21-day probation period during which time the employer has the right to discharge for any reason without notice.
Salary you expect to receive
For security purposes, please answer the following math problem correctly. You must spell out the answer - e.g. fifteen, not 15.