| Name:(First, Middle, Last) |
Date: (day/month/year) |
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| Address: |
Email Address: |
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| City: |
Province: |
Postal Code: |
Phone Number: |
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| Position Applied For: |
Mobile Number: |
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| Anticipated Start Date: |
Years of Experience: |
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| Do you have a current Driver's License? |
Yes
No
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| Do you own your own vehicle? |
Yes
No
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| Are you legally entitled to work in Canada? |
Yes
No
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| Tickets/Certifications: |
Copy Available |
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Journeyman |
Trade:
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Yes
No
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Apprentice |
Year:
1
2
3
Blue Book: |
Yes
No
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CWB |
Exp:
dd/mm/yyyy |
Yes
No
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Fall Protection |
Exp:
dd/mm/yyyy |
Yes
No
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First Aid |
Exp:
dd/mm/yyyy |
Yes
No
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AWP |
Exp:
dd/mm/yyyy |
Yes
No
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CSTS |
Exp:
dd/mm/yyyy |
Yes
No
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RT Forklift |
Exp:
dd/mm/yyyy |
Yes
No
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OH Crane |
Exp:
dd/mm/yyyy |
Yes
No
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Other
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Exp:
dd/mm/yyyy |
Yes
No
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Other
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Exp:
dd/mm/yyyy |
Yes
No
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Previous Work Experience |
| Previous Employer: |
Position: |
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| Dates of Employment - Start Date: |
End Date: |
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| Duties: |
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| Reason for Leaving: |
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| Previous Employer: |
Position: |
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| Dates of Employment - Start Date: |
End Date: |
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| Duties: |
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| Reason for Leaving: |
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Depending on the position applied for, the type of work Whitemud offers may be physically demanding and involve long hours. You may also be required to climb, walk on unstable ground, lift objects weighing approximately 30 - 40 lbs, and clearly hear directions and information given to you in a noisy environment.
Are you aware of anything that would cause you to not be able to carry out the duties of a position with the above noted requirements?
Please explain:
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References |
| Name: |
Phone Number: |
Company Name: |
Position/Title: |
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| Name: |
Phone Number: |
Company Name: |
Position/Title: |
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| Name: |
Phone Number: |
Company Name: |
Position/Title: |
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I authorize Whitemud Ironworks Group Inc. (Whitemud) to make inquires of my past employers, educational institutions and references concerning my prior employment, the verification of my educational background, and personal character. I further authorize all previous employers , educational institutions and other individuals providing references to respond to verbal and written inquiries from Whitemud regarding same. I hereby release all such persons from any liability and damages incurred as a result of providing this information.
I understand that with respect to Privacy Legislation I will not have access to the information provided by my past employers, educational institutions and references.
I certify that all the information contained in this application form is correct. I understand that if I am hired and it is found that this document contains false information it may be the result of my immediate dismissal.
I agree with the above conditions
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