Job Seeker Application Form

Your Availability *

Weekdays

Weekends

Evenings

First Name *

Last Name *

Address

Province

City

Postal Code

Phone Number *

Email Address *

SIN#

Birth Date

Gender:

Do you have an insured vehicle?

Do you have a valid driver's license?

Have you worked with an employment agency before?

If so, which companies?

Where were you assigned to work?

Experience

If you have experience in any of the following trade, please indicate your years of experience in the spaces below:

Other Trade not listed

Are you available for general labour?

Safety Training

WHMIS

H2S

Confined Space

Transportation of Dangerous Goods

CPR

Forklift Certificate

Food Safe

OFA

Other

Equipment List

Reflective Vest

Safety Glasses

Steel Toed Boots

Work Gloves

Steel Toed Rubber Boots

Coveralls

Hard Hat

Fire Retardant Coveralls

Safety Issues

Have you ever submitted a WCB Claim?

Do you have any concerns about working with heights?

Do you have any concerns about working with chemicals?

Do you have a history of back problems?

Do you have any concerns about lifting heavy weights?

Other Medical Concerns

Work ReferencesReference 1

Reference 2

Do you have a criminal record?

Have you ever had a criminal record check done?

Emergency Contact *

Vaccine Status

I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED IN THIS APPLICATION. I UNDERSTAND THAT MISREPRESENTATION OR OMISSIONS OF FACT IS CAUSE FOR DISMISSAL. FUTHER, I UNDERSTAND AND AGREE THAT MY EMPLOYMENT IS NOT NECESSARILY FOR A DEFINITE PERIOD.

By typing my name and the date below, I agree to the above terms.

I consent to Target Personnel & Management contacting me regarding employment *

Thank you! Your submission has been received!

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