Community Living Port Colborne - Wainfleet   A Community Where Everyone Belongs Contact Information Return to our home page.

Home > Employment Opportunities > Application

APPLICATION FOR EMPLOYMENT



Instructions:
1. Fill out the entire form
2. Print the form and sign it for your personal copy.
3. Click the submit button to submit the form.

Position being applied for:
Date application completed:

Personal Data

Full Name:
Street Address:
City: , Province
Postal Code:
Phone w/Area Code:
E-mail Address:


Are you legally eligible to work in Canada?
Have you ever been convicted of a criminal offense for which a pardon has not been granted?
Are you 18 years or more and less than 65 years of age?


To Determine your qualification for employment, please provide below information related to your academic and other achievements including volunteer work, as well as employment history. Additional information may be attached on a separate sheet.


Education

Schooling 1:
Highest grade or level completed:
Name of Program:
Length of Program:
License, certificate or diploma awarded?
Type:

Schooling 2:
Name of Program:
Length of Program:
Diploma / Degree Awarded?





WORK RELATED SKILLS

Describe any of your work related skills, experience or training that relate to the position being applied for:


EMPLOYMENT

(List in order, last or present employer first)

Name of present/last employer:
Address:
Job Title:
Period of Employment:
Reason for Leaving:
Name of Supervisor: Phone Number:
Duties/Functions/Responsibilities:


Name of previous employer:
Address:
Job Title:
Period of Employment:
Reason for Leaving:
Name of Supervisor: Phone Number:
Duties/Functions/Responsibilities:


Name of previous employer:
Address:
Job Title:
Period of Employment:
Reason for Leaving:
Name of Supervisor: Phone Number:
Duties/Functions/Responsibilities:


REFERENCES

For employment references we may approach

Your present/last employer?
Your former employer(s)?


PERSONAL INTERESTS AND ACTIVITIES


PLEASE READ CAREFULLY APPLICANT'S CERTIFICATION AND AGREEMENT

By pressing Submit OR by signing this form, I hereby declare that the foregoing information is true and complete to my knowledge. I understand that a false statement may disqualify me from employment, or cause my dismissal.

 

 

 
Signature
Date




Pressing "Reset" will clear all the fields.

© 2003 Community Living Port Colborne Wainfleet & DJPM