Name: Mr. Miss. Mrs. Ms. Dr. Date Address: Apt # City: Province: Select AB BC MB NB NL NS NT NU ON PE QC SK YT Postal code: Phone: ( ) - Email Address: Date available   SIN: Desired Salary: $ Position Applied for:   Are you a citizen of Canada? Yes No If no, are you authorized to work in Canada?     Yes   No Have you ever worked for this company? Yes No If yes, when Have you ever been convicted of a felony? Yes No   if yes, explain: High School: Address: From: To: Did you graduate? Yes No Degree: College: Address: From: To: Did you graduate? Yes No Degree: Other: Address: From: To: Did you graduate? Yes No Degree: Please list three professional references: Full Name: Relationship: Company: Phone ( ) - Address: Full Name: Relationship: Company: Phone ( ) - Address: Full Name: Relationship: Company: Phone ( ) - Address: Company:: Phone:: ( ) - Address: Supervisor: Job Title: Starting Salary: Ending Salary: Responsibilities: From: To: Reason for Leaving: May we contact your previous supervisor for a reference? Yes No   Company:: Phone:: ( ) - Address: Supervisor: Job Title: Starting Salary: Ending Salary: Responsibilities: From: To: Reason for Leaving: May we contact your previous supervisor for a reference? Yes No   Company:: Phone:: ( ) - Address: Supervisor: Job Title: Starting Salary: Ending Salary: Responsibilities: From: To: Reason for Leaving: May we contact your previous supervisor for a reference? Yes No   You can attach a copy of your resume if you wish to submit it along with this submission. You may also wish to submit a cover letter and/or additional references. Please only submit files in Word (.doc), Adobe Acrobat (.pdf) or Rich Text Format (.rtf) and with a file size lower than 500 Kb.           Attach file:     I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.