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APPLICATION FOR EMPLOYMENT

Russell A. Farrow Limited and its subsidiary companies are equal opportunity employers. Applications are considered for all positions without regard to race, ancestry, place of origin, colour, ethnic origin, citizenship, creed, sex, age, martial status, family status or handicap.
* required fields
Last Name*
 Given Name(s)*
Address*
 Street*
 Apt. No
 Home Phone Number*
City*
 Province*
 Postal Code*
 Business Phone Number
E-MAIL*
  
Are you legally eligible to work in Canada?
Yes No
Are you between 18 and 65 Years of Age?
Yes No
Position being applied for?*
 Date available to begin work
Are you available to work
Full Time Shiftwork Casual Part-time Temporary
From
 To
Salary Expectations
 Location Preferred
Is any member of your family currently employed by Russell A. Farrow Limited? If yes, state name, department and relationship.
Yes No
In case of emergency state name and telephone number of person(s) to be notified:
Primary Contact
Name
 Work Phone Number
 Relationship
Secondary Contact
Name
 Work Phone Number
 Relationship
Are you on lay off and subject to recall? Yes No
Are you aware of any reason which would prevent you from being bonded if required? Yes No
Where you ever employed by Russell A. Farrow Limited or one of its subsidiary companies? Yes No
If yes, which company
Location
Dates
Educational Background
High School
Grade Completed Date
College
Certificate/Diploma Completed Date
University
Degree Completed Date
Other
Work Related Skills
Computer With what microcomputer hardware and software do you have working level skills?
Equipment With what other special machines or equipment do you have working level skills?
Languages What languages, other than english, do you speak/read/write fluently?
Other List any pertinent information not included above which you feel relates to your suitability for employment.
Employment Record

1. Dates: From To:
Company:
Address:
Name of Immediate Supervisor Telephone:
Position held:
For employment purposes, may we contact: Yes No
Final salary:
Reason for leaving: 		Duties & Responsibilities


2. Dates: From To:
Company:
Address:
Name of Immediate Supervisor Telephone:
Position held:
For employment purposes, may we contact: Yes No
Final salary:
Reason for leaving: 		Duties & Responsibilities


3. Dates: From To:
Company:
Address:
Name of Immediate Supervisor Telephone:
Position held:
For employment purposes, may we contact: Yes No
Final salary:
Reason for leaving: 		Duties & Responsibilities
1.

I acknowledge that I have read, fully completed and understand all of this application form.   I hereby certify that the foregoing information is true, complete in every respect and I understand and agree that any false or inaccurate statements or omissions will constitute just cause for dismissal from the employ of the company.

2.

I hereby consent to the Company making personal inquiries as may be necessary in order to verify the information I have provided and release any and all respondents to such inquiries from all liability which may arise from disclosure of such information.
3.
I understand that my employment is conditional upon successfully meeting the health requirements of the job for which I have applied or in which I may be placed and therefore, I agree to submit to a pre-placement medical and to such future medicals as are requested by the Company.  Such examinations may be performed by a Doctor or Nurse of the Company's selection.
4.
I agree to wear such safety devices and clothing as the Company may from time to time require.  I agree to the right of search of property, if requested by the Company.  It is understood that the Company is not responsible for personal property such as clothing, tools, etc.  I agree that the foregoing questions and answers and the results of my medical examination may be used, in confidence, by the Company.


Date:*
 Name:*

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