Employment Application

Date of Application: ______________________

PERSONAL INFORMATION

Name:

Last                                            First                                                      Middle

Present Address:

Street                   City                Prov                  Postal Code

Phone:                                    Cell Number:                             Email:

At your place of Residence is there any POULTRY, PET BIRDS, or PIGS         Yes_____ No ______

Are you related to anyone in our employ

Yes____ No _____

If yes who: __________

Have you ever been employed by Cuddy Farms

Yes____ No _____

If yes where: _________

Who was your supervisor:

Were you referred by a Cuddy employee

Yes____ No _____

If yes who: __________

Are you legally entitled to work in Canada

Yes____ No _____

Have you every been convicted of a criminal offence for which you have not been pardoned Yes_____ No _____

EMPLOYMENT DESIRED

Full Time:

Part Time:

Summer:

Salary:

Start date:

Position:

EMPLOYMENT HISTORY

Former employer starting with your most recent employment

Employer:
Address:
City:
Contact Person:
Phone Number:

Dates:
From:

Salary:

Position held:

Reason for leaving:

To:

May we contact them
Yes _____ No _____

Employer:
Address:
City:
Contact Person:
Phone Number:

Dates:
From:

Salary:

Position held:

Reason for leaving:

To:

May we contact them
Yes _____ No _____

Employer:
Address:
City:
Contact Person:
Phone Number:

Dates:
From:

Salary:

Position held:

Reason for leaving:

To:

May we contact them
Yes _____ No _____

Employer:
Address:
City:
Contact Person:
Phone Number:

Dates:
From:

Salary:

Position held:

Reason for leaving:

To:

May we contact them
Yes _____ No _____

EDUCATION

High School

Date:                  From:                  To:

Diploma:

Did you graduate:        Yes _____ No _____

College/University:

Date:                  From:                  To:

Diploma:

Did you graduate:        Yes _____  No _____

Other:

Date:                  From:                  To:

Diploma:

Did you graduate:        Yes _____  No _____

Please list any other certificates or training you have acquired: (first aid, WHMIS, ladder etc)

REFERENCES

Please provide 3 professional references we may contact. They must have known you for at least one year. Please do not use references of a religious or ethnic nature

Full Name:

Relationship:

Company:

Phone Number:

Full Name:

Relationship:

Company:

Phone Number:

Full Name:

Relationship:

Company:

Phone Number:

Please tell us how you heard about us:

Internet:

Newspaper:

Friend:

Other: 

Signature:

Date: