EMPLOYMENT APPLICATION FORM
Legal Name (Last, First): _____________________________________________ Middle:_____________________
Address: __________________________________________________________ City: _____________________
Province: ______ Postal Code: ____________
Email: _______________________________________________
Cell Phone: _______________________ Home Phone: _____________________ Alt Phone: ___________________
Are you legally permitted to work in Canada?
Do you hold a valid BC Security Worker Licence?
Do you have a valid BC Drivers Licence?
Do you own or have access to a vehicle?
Do you require access to a parking stall?
Yes ____
Yes ____
Yes ____
Yes ____
Yes ____
No ____
No ____
No ____
No ____
No ____
If you are the holder of a B.C. Security Worker Licence or a BST certificate, please provide:
1.
BC Security Worker Licence #: ___________________ Expiry date: _______________
2.
BC BST Certificate #: ____________________
Are you applying for:
Full time
Issued on:_______________
or Part time
(Check One)
How many days (8hr shifts) per week are you looking for: __________________________________________
Are you available to work overtime: Yes: _____ No: ____
Please check off your availability for work (indicate with a tick):
Shift
Hours
Sunday
Monday
7am-3pm
Morning
8am-4pm
3pm-11pm
Afternoon
4pm-12pm
11pm-7am
Night
12pm-8am
Further Details Regarding your Availability:
Tuesday
Wednesday
Thursday
Friday
Saturday
Employment History (Most Recent First):
1
Dates
Employer
__Part time
__Fulltime
Duties
Position
Salary/Pay rate
Position
Salary/Pay rate
Position
Salary/Pay rate
Position
Salary/Pay rate
Position
Salary/Pay rate
Reason for leaving:
2
Dates
Employer
__Part time
__Fulltime
Duties
Reason for leaving:
3
Dates
Employer
__Part time
__Fulltime
Duties
Reason for leaving:
4
Dates
Employer
__Part time
__Fulltime
Duties
Reason for leaving:
5
Dates
Employer
__Part time
__Fulltime
Duties
Reason for leaving:
May we contact your current employer?
__Yes __ No
May we contact the employers listed above?
__Yes __ No
If not indicate by number which one(s) you do not wish us to contact: __1 __2 __3 __ 4 __5
Education History:
High School
Graduated?
1
Details
College/University
Graduated?
2
Details
Other
Graduated?
3
Details
Other
4
Details
Certificates:
Details
Details
Details
Languages spoken besides English
Graduated?
REFERENCES (Professional/Business):
Name
Title
Relationship
Company
Phone
Email
Name
Title
Relationship
Company
Phone
Email
Name
Title
Relationship
Company
Phone
Email
READ CAREFULLY BEFORE SIGNING:
I verify that all of the statements contained on this application are true and correct. I understand that false or
misleading statements on this application, any resume or during any interview may be grounds for immediate
disqualification or dismissal from employment.
I consent to a thorough investigation of my background being made and I authorize my former employers and
other persons or organizations to provide any information they have about my employment background and I
release all concerned from any liability in connection therewith. I understand that if offered a position, I will be
required to submit proof of employment eligibility.
If hired, I agree to be bound by all policies, rules and regulations of my employer.
Any personal information provided in my application, or collected in the future by the company, may be
collected, used, stored and/or disclosed as required to administer my employment application, or for the purpose
of considering me for future employment opportunities with the company. All personal information will be kept
confidential and secure, pursuant to applicable privacy legislation and the company’s privacy policy.
CMI Concierge & Security Inc. is an equal opportunity employer. All employment decisions are to be made
without regard to race, colour, ancestry, place of origin, political belief, religion, marital status, family status,
physical or mental disability, sex, sexual orientation, age or any other basis prohibited by law.
Signature of applicant: _____________________________ Date: __________________