APPLICATION

FOR

EMPLOYMENT

We at Once Upon a Child Kelowna are committed to a policy of equal treatment and opportunity in every aspect of our employment relations without regard to race, ancestry, place of origin, ethnic origin, colour, citizenship, creed, sex, sexual orientation, age, marital status, family status, disability, or any other legally protected class status. This includes, but is not limited to, recruiting, hiring selection for training, transfers, promotion, compensation, and any company sponsored social and recreational programs.

PLEASE PRINT

Name ______Date ______

Address ______

Address CityProvince Postal Code

Email Address Cell Phone or Telephone (___) ______

Referred by ___ Advertisement ___ Facebook ___ Person___ Other ______

Are you legally entitled to employment in Canada? ___ Yes ___ No Are you between 18 and 65? ______

If under 18, please state your age: ______

Position applying for ______

Are you available to work___ Full-time ___ Part-Time Specify schedule limitations ______

Date available for work ______List friends or relatives employed by us ______

Were you previously employed by OUAC? ___ Yes __ No If yes, when & where ______

Other name(s) used while attending schools or places of employment indicated on this form ______

The jobs at Once Upon a Child Kelowna will involve standing for the full shift, lifting and carrying bins weighing up to 25lbs, going up and down stairs and conducting basic math skills. Accomodations may be made for qualified candidates who have certain limitations.

Can you perform the primary functions of this job with or without reasonable accommodation? __ Yes __ No

Have you ever been convicted of a criminal offence for which a pardon has not been granted? __ Yes __ No If yes, please explain: (Note - a conviction alone will not automatically bar you from employment.) ______

______

EDUCATION

Name and Location / Course
of Study / Scholastic
Average / Dates of
Attendance / Graduated
Yes/No / Year / Degree/
Diploma
High School / N/A
Post Secondary
Other
Additional comments regarding education ______
______
______

SKILLS

List Computer Software Packages in which you are proficient ______What languages do you:

______speak fluently ______

Point of Sale System (cash register)______write fluently ______

Other Skills ______read fluently ______

EMPLOYMENT HISTORY

(List present or most recent employer first)

Name of Company ______Address ______

Supervisor ______Salary ______Phone ______

Job Title ______Date Started ______Date Left ______

Job Description ______

______

Reason for Leaving:

Name of Company ______Address ______

Supervisor ______Salary ______Phone ______

Job Title ______Date Started ______Date Left ______

Job Description ______

______

Reason for Leaving:

Name of Company ______Address ______

Supervisor ______Salary ______Phone ______

Job Title ______Date Started ______Date Left ______

Job Description ______

______

Reason for Leaving:

Name of Company ______Address ______

Supervisor ______Salary ______Phone ______

Job Title ______Date Started ______Date Left ______

Job Description ______

______

Reason for Leaving:

AUTHORIZATION FOR BACKGROUND CHECK: I authorize Once Upon A Child Kelowna to verify employment, except as noted below.

Indicate those you do not wish contacted:______

Signed: ______Date: ______

REFERENCES

Please list three persons other than relatives or personal friends, who can judge your work ability.

1) Name ______Occupation ______

Address ______Phone ______

2) Name ______Occupation ______

Address ______Phone ______

3) Name ______Occupation ______

Address ______Phone ______

Please use the space provided below to summarize any additional information necessary to fully describe your qualifications.

______

______

______

______

______

*** PLEASE READ ***

All information written on this application is complete and accurate to the best of my knowledge. I understand that any misrepresentation of facts in this application disqualifies me from further consideration - or if employed - is grounds for dismissal. I understand that any employment offer is contingent upon satisfactory references and I authorize Once Upon A Child Kelowna to investigate past employment and education history, as well as references.

I fully understand and agree to all statements above.

______

SignatureDate

OFFICE USE ONLY

Interviewed by ______Date ______

Referral Source ______Hired ______Not Hired ______

Starting Date ______Position ______Salary ______

Location ______Reporting To ______