NOTE TO APPLICANT:
All information is treated as strictly confidential and subject to investigation. This form must be fully filled in and will be used to evaluate your suitability for employment ALL QUESTIONS MUST BE ANSWERED FULLY
Are you seeking?
FULL-TIME
PART-TIME
CASUAL
Employment not to extend beyond:
Are you between the ages of 16 & 65
Are you legally entitled to work in Canada?
YES
NO
YES
NO
First Name
Last Name
Middle Name
Street Address
City/Town
Major Intersections
Postal Code
Email Address
Home Telephone Number
Business Telephone
Place of residence for the past (10) years excluding present address
Address - Street / Apt No.
City
Prov/State/Country
From
To
Do you own a motor vehicle?
Do you have regular use of a motor vehicle?
YES
NO
YES
NO
Do you have a valid driver’s license?
If Yes... list class(es)
YES
NO
If you are applying for full time employment, can and will you work full rotating (any time day and night) shifts and Weekends?
YES
NO
If no, give reason
If you are applying for a part time position, list which days and times you will be available to work:
If you are applying for a part time position, can and will you commit to working assigned shifts every week?
YES
NO
Can and will you work at any location in the Greater Toronto Area?
YES
NO
How did you hear of us?
Toronto Sun
Local Newspaper (Specify Below)
Internet Posting (Specify Below)
Other (Specify Below)
Specify
If you are presently employed, why do you wish to leave?
EMPLOYMENT RECORD
LIST YOUR EMPLOYMENT HISTORY STARTING WITH YOUR CURRENT/MOST RECENT EMPLOYMENT
Employer’s Name
Start Date
End Date
Address
Type of Business
Telephone Number
Position Held
Final Salary
Supervisor’s Name
Reason for Leaving
Briefly Describe Your Responsibilities
Employer’s Name
Start Date
End Date
Address
Type of Business
Telephone Number
Position Held
Final Salary
Supervisor’s Name
Reason for Leaving
Briefly Describe Your Responsibilities
Employer’s Name
Start Date
End Date
Address
Type of Business
Telephone Number
Position Held
Final Salary
Supervisor’s Name
Reason for Leaving
Briefly Describe Your Responsibilities
Employer’s Name
Start Date
End Date
Address
Type of Business
Telephone Number
Position Held
Final Salary
Supervisor’s Name
Reason for Leaving
Briefly Describe Your Responsibilities
PERSONAL REFERENCES
List two people, other than former/current employers, co-workers or family, to whom we may refer to in confidence.
NAME
ADDRESS
OCCUPATION
PHONE NUMBER
YRS KNOWN
In the event of an emergency, who is to be notified?
Name
Address
City/Town
Telephone
Have you ever been employed by Reilly’s Security?
NO
YES
IF yes, please list location, position and dates:
Do you have or have you had any relatives in our employment?
NO
YES
If yes, please give their names and their relationship to you.
Minimum starting wage expected?
PER
YEAR
MONTH
BI-WEEKLY
WEEKLY
Date available to start work:
Can and will you work overtime if required?
YES
NO
Have you ever been convicted or found guilty of an offence under the laws of any country, province or state?
NO
YES
If yes, list the details below:
OFFENCE
DATE
PLACE
POLICE DEPT.
SENTENCE
Is or has your driver’s licence been under suspension?
YES
NO
If yes, give details:
Have you ever been bonded?
NO
YES
If yes, give details:
EDUCATION
Secondary School Name
Number of Years
Last Grade Completed
Year Completed
Course of Study
College/University Name
Number of Years
Last Year Completed
Degree Obtained
Course of Study
YES
NO
Business/Trade School
Number of Years
Last Year Completed
Diploma Obtained
Course of Study
YES
NO
LIST ANY SPECIAL TRAINING OR SCHOOLING LISTING CERTIFICATES / DIPLOMAS
SKILLS – Please list the training and or experience you have in the following categories
TRAINING
EXPERINCE
TRAINING
EXPERINCE
W.H.M.I.S
YES NO
YES NO
Self Defense - List
YES NO
YES NO
C.P.R. - Basic Rescuer
YES NO
YES NO
Typing/Keyboarding
YES NO
YES NO
C.P.R. - Heartsaver
YES NO
YES NO
Handcuffing
YES NO
YES NO
First Aid - Emergency
YES NO
YES NO
Use of Force - Specify
YES NO
YES NO
First Aid - Advanced
YES NO
YES NO
Computer – List Courses/Programs and Experience
Others (Give Details)
Are you fluent in English?
Are you fluent in French?
YES
NO
NO
YES
Other(s)
NO
YES
List Others
Have you ever been fired, discharged, terminated or asked to resign?
NO
YES
If yes, list companies, dates, and circumstances
May we contact your present employer?
May we contact your previous employers?
NO
YES
NO
YES
I declare that, to the best of my knowledge, all of the information contained in this application is accurate, complete and true. I Authorize Reilly’s Security Services (“RSS”) to verify all information contained on this application, including conducting credit references and verifying employment history with third parties. I understand that any false statements shall be sufficient reason to disqualify me from employment and constitute just cause to preclude me from continued employment, if I am employed.
If I am employed, I agree to maintain confidential all information, procedures, policies and other matters pertaining to RSS, its clients and employees. I also agree that failure to comply with this requirement will result in disciplinary action up to and including termination of employment.
If I am employed by RSS, I agree to abide by the Conditions of Employment (as amended from time to time), a copy of which I will be given to read and sign prior to starting employment. I also agree to abide by and follow all posted orders, instructions, and regulations. I acknowledge and agree that failure to comply with the above provisions will result in disciplinary action up to and including termination of employment for just cause.
I acknowledge and agree that I have fully disclosed and not misrepresented my ability to comply with the conditions of my employment, including but not limited to my ability to work anywhere in the Municipality of Toronto and the Greater Toronto Area (“GTA”); and to work regularly rotating shifts, as assigned by the employer. I further acknowledge and agree that misrepresentation of my ability to meet, or failure to comply with the conditions of my employment may result in disciplinary action up to and including termination for just cause.
If I am employed by RSS, I agree to produce acceptable evidence of my immunization status or to obtain and maintain an immunization status, acceptable to RSS if required.
I acknowledge and agree that if employed, my employment may be terminated at any time and from any position held, by the provision of notice, termination pay or severance pay or any other payment as prescribed by the Employment Standards Act and that shall be my full and final entitlement upon termination.
I acknowledge and agree that the first ninety days of my employment are probationary and that my employment may be terminated during this period at the full discretion of RSS without cause or notice to me. I also acknowledge and agree that my probation period may be extended, at the full discretion of RSS, at any time.
I have carefully read the above, understand the terms of this application form and agree to abide by them.
I AGREE
I DO NOT AGREE