Application Form
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Social Insurance Number (Optional, will be required upon hire.)
Email
example@example.com
Main Phone Number
*
Format: (000) 000-0000.
1. How did you hear about us? (Select One)
*
Please Select
Avia
College/Education Centre
Company Website
The Universal Group (Flagging Department)
Universal Health & Safety (UHS)
Craigslist
Fraser Works
Facebook
GT Hiring Solutions
Indeed
Institutions
ISSofBC
Job Fair
Phoenix
Referral/Friend
S.U.C.C.E.S.S.
Walk-In
WorkBC
ACES - John Howard Society
Other
2. Are you a citizen of Canada?
*
Yes
No
3. If no, are you authorized to work in Canada?
Yes
No
4. General Availability (Example: Type 7-7)
*
Rows
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Morning (Shifts Start, 7 AM)
Evening (Shift Start, 3 PM)
a) Are there any days of the week/hours you absolutely cannot work?
b) Notes/Future Adjustments:
5. Please indicate any experience you have in the following areas:
Rows
No Experience
1 Year
2 Years
3 Years
4 Years
5 Years +
Janitor (School)
Janitor (Hospital)
House Cleaner
Cleaning Supervisor
Housekeeper
Exterior Cleaner
Detail Cleaner
6. Do you have any of the following tickets?
*
Building Services Worker Certificate
WHMIS (Non expired, valid ticket)
Construction Safety Officer
Intermediate First Aid
Advanced First Aid
None
7. Other Related Work Experience / Skills you'd like to share with us?
8. Previous job title.
9. Reliable Transportation (Please choose)
*
Please Select
Transit
Car
Both
10. Please attach a copy of any certifications
Browse Files
Drag and drop files here
Choose a file
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11. Please list all work references (Employer/Relationship/Phone):
*
12. Do you have any physical limitations or medical conditions that may affect your ability to perform certain tasks or activities? (Leave empty if none)
13. For any questions & concerns, please let us know below:
Emergency Contact 1
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
Emergency Contact 2
First Name
Last Name
Phone Number
Format: (000) 000-0000.
Once completed, please ensure that all information is as correct and accurate as possible, and then click submit.
Signature or Initial:
*
Submit
Should be Empty: