Please complete all details of your application
Thank You

General Information

Name (Last) :
Name (First and Middle) :
Social Insurance Number :
Address :
City :
Prov/Terr/State :
Postal Code :
Telephone :
Email :
A: Do you have a reliable means of transportation to get to work :	Yes No
B: If hired when can you start work :
C: What position are you applying for :
D: If you are currently a student please indicate which grade/level you are enrolled in as of today's date :
E: Last day you are available for regularly scheduled shifts if returning to school :
F: Are you available to work fulltime :	Yes No
G: Are you available to work parttime :	Yes No
H: Can you work shifts :	Yes Evenings Weekends
I: What unique qualifications, information, skills or experience would you bring to The Sou'Wester:
J: Once you have returned to school, are you able to work :	Yes No
K: If yes please specify the hours you are able to work for each day of the week :
L: If you are able to work only weekends, are you willing and able to work every weekend until Thanksgiving :	Yes No
Education
High School name :
Course of study :
Number of years :	1 2 3 4
Did you graduate :	Yes No
Degree earned :
College/Vocational School name :
Course of study:
Number of Years :	1 2 3 4
Did you graduate :	Yes No
Degree earned:
Employment History ( Please start with your present or most recent position)
Employer #1 :
Phone :
Address :
Supervisor's Name and Title :
Starting date :
Ending date :
Salary :
Describe the type of work you did :
Explain your reason for leaving :
May we contact this employer :	Yes No
If no, explain :
Employer #2 :
Phone :
Address :
Supervisor's Name and Title :
Starting date :
Ending date :
Salary :
Describe the type of work you did :
Explain your reason for leaving:
May we contact this employer :	Yes No
If no, explain :
Employer #3 :
Phone :
Address :
Supervisor's Name and Title :
Starting date :
Ending date :
Salary :
Describe the type of work you did :
Explain your reason for leaving :
May we contact this employer :	Yes No
If no, explain :
Professional References
Name/Title :
Phone :
Organization :
Address :
Association with you :
Name/Title :
Phone :
Organization :
Address :
Association with you :
Name/Title :
Phone :
Organization :
Address :
Association with you :
Please Read Carefully : The foregoing statements are correct to the best of my knowledge. I understand that any misrepresentation may disqualify me from employment or be cause for dismissal. If hired, I agree to abide by all rules and regulations of the employer which may include signing an employment confidentiality contract and serving an initial probationary period.
I acknowledge to have read all of the above :	Yes No
Application date :