CANADIAN TEAM MEMBER APPLICATION

Date:

Position Applying For:

 

Personal Information

Last Name:

First Name:

Middle Name:

Home Phone Number:

Mobile Phone Number:

Address (current):

City:

State:

Zip:

Email Address:

 

Education/Skills

Junior/High School

College/University

Business/Trade

Other

Are you at least 18 years of age?

Yes No

Are you legally able to work in Canada?

Yes No

Do you have a valid Driver's License?

Yes No

Do you have a Social Insurance Number?

Yes No

Have you ever been convicted of an offence other than a traffic violation, for which you have not been granted a pardon?

Yes No

If yes, please explain:

Have you ever worked for us before?

Yes No

If yes, when?

Do you have relatives employed by this company?

Yes No

Employee name and department:

Do you have any limitations that would preclude you from performing any functions of the position you are applying for?

Yes No

If yes, explain & advise of any accommodations which may be required:

 

Hours Available

Number of hours available to work per week:

Times not available:

Earliest Time Available:

Sunday

 

Monday

 

Tuesday

 

Wednesday

 

Thursday

 

Friday

 

Saturday

Latest Time Available:

Sunday

 

Monday

 

Tuesday

 

Wednesday

 

Thursday

 

Friday

 

Saturday

 

Employment History

List your last three positions, starting with present or most recent employer. It is understood that :10 Minute Manicure reserves the privilege of contacting past employers regarding references.

If you are currently employed, may we contact your employer at this time?

Yes No

1. Name of Company:

Phone Number:

Position Held:

Employment Dates:

From: To:

How Long (years/months):

Name of Supervisor:

Rate of Pay:

Start: $ Final: $

Brief Description of Duties Performed:

Reason for leaving:

2. Name of Company:

Phone Number:

Position Held:

Employment Dates:

From: To:

How Long (years/months):

Name of Supervisor:

Rate of Pay:

Start: $ Final: $

Brief Description of Duties Performed:

Reason for leaving:

3. Name of Company:

Phone Number:

Position Held:

Employment Dates:

From: To:

How Long (years/months):

Name of Supervisor:

Rate of Pay:

Start: $ Final: $

Brief Description of Duties Performed:

Reason for leaving:

 

References

Please list three references we may contact:

Name:

Phone (work):

Phone (home):

Name:

Phone (work):

Phone (home):

Name:

Phone (work):

Phone (home):

 

Tell us why you are a great candidate for this position:

 
 
I certify that my answers to these questions are complete, true and correct to the best of my knowledge. I understand that if employed, falsified statements, misrepresentation, or omission of facts may be cause for termination. I hereby consent to the release of all relevant information obtained from any agency including references, security checks and credit investigations.
 
 

Date:

Signature: