New Worker Registration Form

New Worker Registration Form

Please complete all answers as required for employee/contractor orientation.
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If you require technical assistance, please click here to contact our team.
Type of worker:*

Employee of Bluetick EnterprisesContract Worker (DSP/self employed/owner operator/etc)Subcontractor Company (multiple workers)Employee of Subcontractor Company
Type of worker:*

Employee of Bluetick EnterprisesContract Worker (DSP / self employed / owner operator /etc)Subcontractor Company (multiple workers)Employee of Subcontractor Company

Full Legal Name:*

First NameLast Name
Date of Birth:*

MonthDayYear
Date
Cell Phone Number*
Name of Cell Carrier*
Select One
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you have a drivers license?*

YesNo

Health Care Number:*
Issuing Province of Health Care Card:*
Need Help?

	Number	Class	Issuing Province	Special conditions (if none, list N/A)
Drivers License

Emergency Contact Information
Personal Emergency Contact Person:*

First NameLast Name
Personal Emergency Contact Phone: *
Relationship to Emergency Contact:*
Please describe any Medical Considerations that directly affect your ability to safely perform this job or your safety at the worksite. (ex. allergies, medications, pre-existing injuries, etc).

Employees, please submit:
- void cheque,
- tax forms (fillable copies below - click to download and save),
- copy of your drivers license, and
- copy of driver's abstract (must be dated within 30 days of hire)
to Bluetick ADMIN blue_tick@live.ca
Contractors, please submit:
- void cheque,
- copy of your drivers license, and
- copy of driver's abstract (must be dated within 30 days of hire)
to Bluetick ADMIN blue_tick@live.ca
Employees of Subontractors, please submit a copy of your drivers license

to admin@huttonsafetygroup.com

Contractors and/or Subcontractors Roles & Responsibilities:
- Implement and follow an effective health and safety program, or follow the health and safety program that is in place to protect other workers not under the employer’s direction;
- Conduct work safely by ensuring workers are competent to do so;
- Be aware of and meet the operating company's safety expectations;
- Ensure work conducted complies with contractual agreements and regulatory requirements;
- Provide the resources necessary to allow workers to complete their work safely;
- Complete the Pre-Qualification of Subcontractors.
Click HERE to access the Federal TD-1 Form

Click HERE to access the TD-1AB Form

**To complete the tax forms:
- Open the link
- Complete the form on your device
- SAVE the file
- Email to the above contact(s)
By signing this, I agree that I have read and understand my responsibilities as a contractor/subcontractor. I will comply with all components of the Health and Safety Management System as I understand it is in alignment with the requirements of OH&S laws and regulations applicable to the jurisdictions that Bluetick works in. I also agree that I will adhere to my roles and responsibilities outlined in the Subcontractor Management Program.*

I agreeI do not agree
By completing this form I understand that the above information is required to participate in the Bluetick Corporate Safety Program. I will comply with all components of the system, as I understand it is in alignment with the requirements of OH&S laws and regulations applicable to the jurisdictions that Bluetick works in.*

I agreeI do not agree
Your Signature:*
Should be Empty:

New Worker Registration Form

Emergency Contact Information

Job Information

Certificate Information

Contractor Company Information

WCB Information

Insurance

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Transportation

Subcontractor Management