Employment Application

 

* must be filled in.
Personal Information
*Family Name
 *First Name
Address  (No., Street, Apt. No., City, Province, Postal Code)
Home Telephone
()
Business Telephone
()
 
 
Are you 15 years of age or older?
 
 
Family or friends at Calgary Co-op?
 
 
Have you worked for Calgary Co-op before?
If yes, when?
 
 
Have you ever been discharged from any position? If yes, explain.
( in comments section below )
 
 
Have you ever been convicted of an offence(s), for which you have not received an unrevoked pardon, under the Criminal Code, the Food & Drug Act or Narcotic Control Act?
If yes, explain. ( in comments section below )
 
 
Do you have any illness, disability or physical limitations which may prevent you from regularly lifting or carrying 10kg?
 
 
Are you legally entitled to work in Canada?
If on temporary work permit, what is the expiry date?
 
 
Do you have any illness, disability or physical limitations which may prevent you from doing work of a repetitive nature?
Job Interest
Store or area of city preferred:
N.W.
N.E.
S.E.
S.W.
Airdrie
Beddington
Brentwood
Creekside
 Crowfoot
Dalhousie
Deer Valley
Eastfield Gas Bar
Forest Lawn
Hamptons
Heritage Town Centre
Macleod Trail
 Midtown Market
Monterey
Northhill
Oakridge
Okotoks
Richmond Road
Rocky Ridge
Shawnessy
 South Trail Crossing
Strathmore
Taradale
Village Square
West Springs
Type of work
1.
2. 		Weekend Work?
 
  		Preference for
 
 
Date available:
 Rate of pay expected:
 Who referred you to this organization?

 

Availability  (Specify for 24 hour period)
HOURS AVAILABLE Sunday Monday Tuesday Wednesday Thursday Friday Saturday
From AM
to PM
Education  (Highest level achieved)
HIGH SCHOOL From Name
  To Location   Province
   
 
 
 Grade
 Achieved required credit or diploma
yes
COLLEGE, UNIVERSITY, BUSINESS, TRADE OR
OTHER SCHOOL 		From Name
To Location   Province
  Specify degree or diploma attained  
Personal References
Give three personal references who have known you well during the last five or more years excluding relatives and former employers. (you may decline to list ministers of religion)
Name
(include first name or initials) 		Address
(No., Street, Apt. No., City, Province, Postal Code) 		Telephone Years Known Present or most recent occupation

 

Employment History
  Check the number of any of the employers whom you do not wish us to contact at this time.
1     2     3
1. Company Name
 Telephone #
()
  Address  (No., Street, Apt. No., City, Province, Postal Code)
  Type of Business

Position
  
 
  		Salary Start

Final
 Employed From

To
  Nature of duties from start to time of leaving (give title, responsibility, supervisory experience, etc.)
  If you were a supervisor,
# of people supervised
 Reason for leaving
 Immediate Supervisor
Name

Title
2. Company Name
 Telephone #
()
  Address  (No., Street, Apt. No., City, Province, Postal Code)
  Type of Business

Position
  
 
  		Salary Start

Final
 Employed From

To
  Nature of duties from start to time of leaving (give title, responsibility, supervisory experience, etc.)
  If you were a supervisor,
# of people supervised
 Reason for leaving
 Immediate Supervisor
Name

Title
3. Company Name
 Telephone #
()
  Address  (No., Street, Apt. No., City, Province, Postal Code)
  Type of Business

Position
  
 
  		Salary Start

Final
 Employed From

To
  Nature of duties from start to time of leaving (give title, responsibility, supervisory experience, etc.)
  If you were a supervisor,
# of people supervised
 Reason for leaving
 Immediate Supervisor
Name

Title
Other Time
Account for your time during any interval of unemployment other than when you were attending school. You may decline to list any illnesses or leaves of absence relating to disability.
From

To
 Explanation
From

To
 Explanation
Additional Information/Comments
Application Statement

I understand that the personal information on this form is being collected for the purpose of establishing and maintaining an employment relationship and may be disclosed without my further consent within Calgary Co-operative Association Limited. The personal information will not be disclosed to any third party, other than for the purpose of verifying my employment, without my consent. By signing below I am consenting to the collection, use and disclosure of this information by Calgary Co-operative Association Limited for the purposes stated. I understand that if this application does not result in employment with Calgary Co-operative Association Limited, that the application and personal information contained herein will be retained for six months and then destroyed.

In signing this application, I understand that any misrepresentation of omission of facts is cause for cancellation of this application or termination of emmployment. I hereby consent to have an investigation of work and personal references, security check, and a credit investigation conducted.
Signature of applicant
 Date