DCI Cleaning Ltd - Online Employment Application Form

Full Name*

PrefixFirst NameMiddle NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

E-mail*

Are you currently employed?*

YesNo

Are you legally entitled to work in Canada?*

YesNo

Have you worked at DCI Cleaning Ltd before?*

YesNo

If yes, when?

MonthDayYear

If hired, when are you available to begin work?*

MonthDayYear

Do you have a reliable method of transportation to get to work?

YesNo

Are you bondable?*

YesNo

Have you ever been convicted of a criminal offence for which a pardon has not been granted?*

YesNo

If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.

What type of work are you seeking?

Full timePart timeTemporaryAny of the above

What type of work are you interested in doing?

How did you hear about the job vacancy? Ex: HRDC Job Bank, Current Employer (Please include name of current employer), CB Post, etc.

Select highest level of education completed

List any specialized training, skills and other education. Example: OHSE Training, WHIMIS, First Aid, etc

Present or last employer

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Type of business

Your job title

Start Date

MonthDayYear

End Date (Pick today's date if still employed)

MonthDayYear

Name and Title of immediate supervisor

Reason for leaving

Describe job duties and responsibilites

May we contact your present or last employer for references?

YesNo

Present or last employer

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Start Date

MonthDayYear

End Date

MonthDayYear

Name and Title of immediate supervisor

Reason for leaving

Describe job duties and responsibilites

May we contact your previous employers for reference?

YesNo

Present or last employer

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Start Date

MonthDayYear

End Date

MonthDayYear

Name and Title of immediate supervisor

Reason for leaving

Describe job duties and responsibilites

May we contact your previous employers for reference?

YesNo

By clicking typing your name below, and "submit" at the bottom of this form, you agree to the following: In exchange for the consideration of my job application by DCI Cleaning Ltd (hereinafter called "the Company"), I agree that: The acceptance of this application shall not serve to create an actual or implied contract of employment, or to confer any right to be or remain an employee of DCI Cleaning Ltd. I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and hereby release the Company from any liability as a result of such contract. I understand that, in connection with the routine processing of my employment application, DCI Cleaning Ltd. may request information as to my character, general reputation, personal characteristics, and general work history. All personal information collected in the application form and/or through investigation (background checks) is confidential information, will be treated as such and safeguards put in place to protect the information. In addition, the information collected will only be used for the purpose it is collected.

Applicant Signature (please type your name. by typing your name you are signing and agreeing to the above application waiver)

Date

MonthDayYear

Enter the message as it's shown*

Employment Application Form

PERSONAL DATA

EDUCATION

WORK HISTORY 1

WORK HISTORY 2

WORK HISTORY 3

PLEASE READ CAREFULLY: Application Waiver