KINGSWAY LODGE (ST. MARYS) LTD.
APPLICATION FOR EMPLOYMENT
Position Applied For:
Date of Application:
Salary or Wage Expected:
PERSONAL DATA
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Last Name |
First Name |
Middle Name |
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Present Address |
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City |
Province |
Postal Code |
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Home Telephone Area Code ( ) |
Business Telephone Area Code ( ) |
Are you employed now? |
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Are you legally entitled to work in Canada? |
Have you worked here before If yes, When? |
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If hired, when can you start work? |
Do you have a reliable means of transportation to get to work? |
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Have you ever been convicted of a criminal offence for which a pardon has not been granted? |
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Are you 18 years of age or older and less than 65 years of age? |
Do you want to work: Full time 1 Part-time 1 Temporary 1 Casual 1 |
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What type of work are you interested in doing? |
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EDUCATION
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Secondary School |
College or University |
Graduate or Professional |
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Year last attended |
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Level completed |
9 10 11 12 13 |
1 2 3 4 5 |
1 2 3 4 5 |
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Certificates, diplomas degrees obtained |
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Course of Study |
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List any specialized training, apprentice skills, awards, professional designations, and other education. |
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Education levels achieved and degrees obtained are subject to verification if an offer of employment is extened. |
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WORK HISTORY
(List in order starting with your present or last job)
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Present or Last Employer |
Address |
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Type of business |
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Your Job Title |
Period Employed From: To: |
Final Salary |
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Name and title of immediate supervisor |
Reason for leaving |
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Describe job duties and responsibilities
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Present or Last Employer |
Address |
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Type of business |
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Your Job Title |
Period Employed From: To: |
Final Salary |
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Name and title of immediate supervisor |
Reason for leaving |
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Describe job duties and responsibilities
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Present or Last Employer |
Address |
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Type of business |
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Your Job Title |
Period Employed From: To: |
Final Salary |
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Name and title of immediate supervisor |
Reason for leaving |
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Describe job duties and responsibilities
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May we contact your present or last employer for reference? Yes 1 No 1 |
May we contact your previous employers for reference? Yes 1 No 1 |
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Is there any other information we should know about you? Yes (If yes explain below) No
AUTHORIZATION
I authorize Kingsway Lodge to contact my former employers and, if hired, my present employer for reference and release from liability any person or company furnishing such references. To the best of my knowledge, the above information is complete and correct. I acknowledge that false or omitted information may be grounds for dismissal. If hired, I agree to comply with all Company Regulations, guidelines, policies and safety rules, including serving an initial probationary period.
I also understand that shift rotations are subject to change. Therefore, employment at Kingsway Lodge is contingent upon all team members being able to work a 3 shift rotation or any combination of day, afternoon, night shift and weekends as required.
Signature Date