Personal Information

Last Name:		First Name:		Initial:
Address:		City/Prov:		Postal Code:
Phone:		Fax:

Name Used In Previous Employment For Purposes of Reference Check:

Position Applied For:		Have you worked for our dealership before?
Rate of Pay Expected:		If yes, when?
Applying For: Full Time	Part Time
If part time, specify days / hours:		Do you have relatives working in our dealership?
If hired, what date will you be available for work?		If yes, indicate relationship/dept:

Are you of legal age (18 years) to work in Alberta?	Yes No	Are you legally permitted to work in Canada?	Yes No
Do you have transportation to commute to work?	Yes No	Driver's license number:
Have you ever been convicted of a criminal offense?	Yes No	Has your driver's license ever been suspended?	Yes No

If yes, explain

Are you available for shift work, travel, overtime work or other duties outside normal working hours on short notice?	Yes No
Some jobs at our dealership do require heavy lifting or other physical job requirements such as standing for lengthy periods, twisting, reaching and working in confined spaces, and other duties which require strength, dexterity and endurance. Do you feel you are capable of performing the duties as outlined?	Yes No

Not applicable to job being applied for

N/A

Education Background

	High School	Undergraduate College / University	Graduate / Professional
Grade Completed
Diploma / Degree
Describe Course of Study

Describe any specialized training, apprenticeship skills or extra - curricular activities:
Describe any honors you have received:

Prior Work History ( List in Order, Last Or Present Employer First)

Our policy is to obtain a continuous employment record from every applicant and to obtain references from all past employers. If you ask us not to contact your current employer, we reserve the right to hire you subject to a positive reference check completed after employment. If there are gaps in your employment record, please fill in the form to indicate what you were doing in those gaps and provide a reference.

Dates

From:

To:

Name/Address of Employer:

Job Description:

Rate of Pay:

Reason for leaving:

Supervisor's Name & Title

Dates

From:

To:

Name/Address of Employer:

Job Description:

Rate of Pay:

Reason for leaving:

Supervisor's Name & Title:

Dates

Name/Address of Employer:

Job Description:

Rate of Pay:

Reason for leaving:		Supervisor's Name & Title:
May we contact the employers listed above?

Personal References

Organization	Name / Occupation	Telephone Number

Applicant's Certification And Agreement

I certify that the statements made by me in this application are true and complete. I understand that a false statement may disqualify me from employment or result in dismissal without notice if I am employed by the dealership.

Signature:

Your application will be kept on file for future reference in the event that we have an employment opportunity in the area you indicated interest in. We will contact you should an interview be required.