Always Care: Employment

Tel: 416-222-4460
fax: 905-770-7073
York Region: 905-770-8511

Employment

Position being applied for:
Date Available to work:

Are you legally eligible to work in Canada?
Date of birth:

In case of emergency, please contact: (name, address, telephone number)

Address:
Apt #
Home phone number:
Business phone number:

To determine your qualification for employment, plaese us with information related to your academic and other achievements including voluntary work as well employment history.

Education
Secondary School		Business, Trade or Technical School
Highest grade or level complete:		Name of course:			Length of course:
		Name of course:			Length of course:
Type of certificate or diploma received:		License, certificate or diploma awarded? Yes No
		License, certificate or diploma awarded? Yes No
Community College		University
Name of program:	Length of program:	Length of course:	Degree awarded		Pass:
			Yes	No	Honours:
Diploma received?		Major Subject:
Yes No
Other courses, workshops, seminars:		License, certificate or degrees:

Work related skills:
Describe any of your work related skills, experience, or training that relate to the position being applied for:

Employment
Name and address of present/last employer:		Present/last job title:
Employer:		Period of employment:
Address:		From:
		To:
Types of business:		Name of supervisor:

		Telephone number:
Duties/Responsibilities:
		Reason for leaving:

Other courses, workshops, seminars:

Name and address of present/last employer:		Present/last job title:
Employer:		Period of employment:
Address:		From:
		To:
Types of business:		Name of supervisor:

		Telephone number:
Duties/Responsibilities:
		Reason for leaving:

Other courses, workshops, seminars:

Name and address of present/last employer:		Present/last job title:
Employer:		Period of employment:
Address:		From:
		To:
Types of business:		Name of supervisor:

		Telephone number:
Duties/Responsibilities:
		Reason for leaving:

Other courses, workshops, seminars:

Have you ever been convicted of a criminal offence for which a pardon has not been granted?			Yes	No
May we request a criminal reference check for:
Criminal convictions:	Yes	No
Outstanding criminal charges	Yes	No
For employment references, may we approach:
Your present/last employer?	Yes	No
Your former employers?	Yes	No
List references if different than above on a another page (Click here)

Activities (Civic, athletic, etc.,):

Please list all languages you can speak and or write:
A:	B:
C:	D:
Hobbies/Talents: Please identify those hobbies or talents which have given you an above-average score, IE: photography, playing a musical instrument, singing, dance, craft, public speaking, sporting activity etc.

Training Courses:
Do you have a valid driver's license?	Yes	No
CPR:	Yes	No
First Aid:	Yes	No
Fire Safety:	Yes	No
Sign Language:	Yes	No
Swimming:	Yes	No

List relevant training courses attended:

List any other skills not mentioned in this form:

Are you presently enrolled in any skill-building program? If yes, please specify.


I hereby declare that the foregoing information is true and complete to my knowledge and I understand that a false statement may disqualify me from employment, or cause my dismissal.