Employee Applicationform

7/29/2019 Employee Applicationform

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APPLICATION FOR EMPLOYMENT

(ANSWER ALL QUESTIONS)

In compliance with the Federal, State and Provincial equal employment opportunity Laws, qualified

applications are considered for all positions with out regard to race, color, Religion, sex, national origin,age, marital status, or the presence of non job related medical condition or handicap.

Position (s) Applied For Date

Name (First) (Middle) (Last)

Address

City Province/State Postal/Zip Code

S.I.N. Phone Email

(If address above less than 3 years, list previous address below)

How Long? Circle time unit.

Address

Days / Weeks / Years


How Long? Circle time unit.

Address



Date of Birth

Can you supply proof of age? Yes No

Health Card Number Marital Status

In case of emergency notify

PERSONAL HISTORY



Have you worked for this company before?

If Yes Date (From-to) Where?

Rate of Pay Position Reason for Leaving

Are you employed now? Yes No

If not, How long since leaving last employ? Circle Time unit. Days / Weeks / Years

Who referred you? Rate of Pay expected

List any handicap that prevents you from doing certain types of work

Are you physically capable of heavy work? Yes No

Ever injured on the job? Yes No

Give nature, and degree of injuries

How much time lost from work in the past 3 years from illness? Circle time unit.


Would you be willing to take a physical examination? Yes No

(Note: List employers in reverse order starting with the most recent.)

Employer Name Date (from-to) Position

Address City

Province/State Postal/Zip Code Phone

PHYSICAL HISTORY

EMPLOYMENT HISTORY




Address City



Address City


Highest Grade Completed School Attended City

EDUCATION

EXPERIENCE AND QUALIFICATIONS



Date Applicant Signature

Please mail this form in confidence to:

Bright-Light Network Solutions

Attention: Human Resources Department

1288 Ritson Road North, Suite 376

Oshawa, Ontario, L1G 8B2

Canada

Employee Application.Doc 2011.12.07

TO BE READ AND AUTHENTICATED BELOW

This certifies that completed this application, and that all entries on it and

information in it are true and completed to the best of my knowledge.

I authorize you to make such investigations and inquiries of my personal,

employment, financial or medical history and other related matters as may benecessary in arriving at an employment decision, I hereby release employers,

schools or persons from all liability in responding to inquiries in connection with

my application.

In the event of employment, I understand that false or misleading information

given in my application or interview(s) may result in discharge. I understand also

that I am required to abide by all rules and regulations of the company, as

permitted by law.

Documents

Employee Applicationform