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Application for Employment / 2012-13

Application for Employment

Date: ______Time: ______

PERSONAL

Name: ______

Surname Middle First

Present Address: ______

No. Street City Province Code

Telephone: ( ) _____ - ______

Job(s) applied for: 1.______Rate of pay expected $______per _____

2.______Rate of pay expected $______per _____

How did you learn of this opening?______

Do you want to work Full Time Part Time

Specify days and hours if part-time:

______

Are you willing to have your name included on the Twin Anchors spare board?

YES NO

Have you worked for us before? ______If yes, when? ______

If hired, on what date will you be available to start work? ______

Are you Bondable? (This is a mandatory field) YES NO

Please Sign:______

Are there any other experiences, skills or qualifications which you feel would especially fit you for work with us? (If necessary, additional space is provided to complete this section on page 3 under Personal References.) Please exclude activities which would indicate any prohibited grounds of discrimination above. ______

______

______

______

______

If hired, do you have reliable means of transportation to get to work? ______

EDUCATION BACKGROUND

Elementary

/

High School

/ Undergraduate College or
University /

Graduate/Professional

Years Completed / 4 5 6 7 8 / 9 10 11 12 13 / 1 2 3 4 / 1 2 3 4

Diploma/

Degree

Describe Course of Study

(Do Not Give Name of School)
Describe any specialized training, apprenticeship skills and extra-curricular activities.
Describe any honours
you have received

PRIOR WORK HISTORY: List in order, starting with present or most current employer first

Dates

From (yymmdd) to (yymmdd) /

Name and Address of Employer

/

Last Rate of Pay

/ Supervisor’s Name and Title / Reason for Leaving
Describe in detail, the work you performed:

Dates

From (yymmdd) to (yymmdd) / Name and Address of Employer / Last Rate of Pay / Supervisor’s Name and Title / Reason for Leaving
Describe in detail, the work you performed:

Dates

From (yymmdd) to (yymmdd) / Name and Address of Employer / Last Rate of Pay / Supervisor’s Name and Title / Reason for Leaving
Describe in detail, the work you performed:

Any additional employers should be added to a separate page and attached accordingly.

May we contact the employers listed above? ______if not, indicate below which one(s) you do not wish us to contact.

PERSONAL REFERENCES

Give the names of at least 3 persons who are able to supply information pertinent to your job performance and character, (excluding former employers or relatives)

Name and Occupation / Address / Phone Number
1. ______ / ______
2.______ / ______
3.______ / ______
4.______ / ______
5.______ / ______

***Government policies, regulations and guidelines, as well as Twin Anchors goal to provide a safe and healthy workplace, makes it necessary for all applicants for employment to complete a criminal record check. This form will be provided and you will be requested to attend to the responsible police office for the purpose of this process.

To assist in finding the appropriate position for you in our company, use the space below to summarize any additional information necessary to describe your full qualifications.

______

____________

PLEASE READ CAREFULLY

APPLICANT’S CERTIFICATION AND AGREEMENT

1.  I hereby certify that the facts and information provided by myself in this employment application are true and complete to the best of my knowledge. I understand that if employed, falsified statements on this application shall be considered sufficient cause for dismissal.

2.  I hereby agree to the following work schedule for the year ______:

-  Monday to Thursday, 10 hours per work day, averaging at 40 hours per week.

-  Overtime will be paid after 40 hours worked per week.

Signature of Applicant: ______Dated: ______

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Twin Anchors Marine/TA Structures

Divisions of Twin Anchors Marine (1977) LTD.

675 Old Town Road, PO Box 318

Sicamous, B.C., Canada V0E 2V0