Kimberley Seldon Design Group

careers application form

Personal Information
Name:
Date:
Address:
City:
Province:
Postal Code:
Phone:
Other Phone:
Email:
Reffered By:

List previous three (3) educational institutions attended, beginning with the most recent.

School 1
School Name:
City/Province:
Graduated?	Yes No
Degree(s)/Diplomas Earned

School 2
School Name:
City/Province:
Graduated?	Yes No
Degree(s)/Diplomas Earned

School 3
School Name:
City/Province:
Graduated?	Yes No
Degree(s)/Diplomas Earned

Provide the following information beginning with the most recent employer.

Employment Position 1
Employer:
Telephone:
Address:
Job Title:
Supervisor Name and Title:
Reasonf for Leaving:
May we contact for reference?	Yes No
Dates Employed
From:
To:
Hourly Rate/Salary
Starting: ($)
Final: ($)
Summarize the type of work performed and responsibilites:

Employment Position 2
Employer:
Telephone:
Address:
Job Title:
Supervisor Name and Title:
Reasonf for Leaving:
May we contact for reference?	Yes No
Dates Employed
From:
To:
Hourly Rate/Salary
Starting: ($)
Final: ($)
Summarize the type of work performed and responsibilites:

Employment Position 3
Employer:
Telephone:
Address:
Job Title:
Supervisor Name and Title:
Reasonf for Leaving:
May we contact for reference?	Yes No
Dates Employed
From:
To:
Hourly Rate/Salary
Starting: ($)
Final: ($)
Summarize the type of work performed and responsibilites:

Employment Position 4
Employer:
Telephone:
Address:
Job Title:
Supervisor Name and Title:
Reasonf for Leaving:
May we contact for reference?	Yes No
Dates Employed
From:
To:
Hourly Rate/Salary
Starting: ($)
Final: ($)
Summarize the type of work performed and responsibilites:

COMMENTS (including any gaps in employment)

What was the best job you’ve ever had? Why did you like it so much?

What was your least favorite job? What did you NOT like about it?

Who was the best supervisor or manager you’ve had? What characteristics made that person a good manager?

Think of the WORST supervisor or manager you’ve had. What characteristics made that person a POOR manager?

What are your greatest strengths?

As your skills and abilities relate to your work experiences, what are the areas for improvement?

What traits or characteristics do you most admire in co-workers?

What traits or characteristics do you most DISLIKE in co-workers?

If you won five million dollars in the lottery, would you choose to work? What would you do with your time?

What was the funniest thing that ever happened to you at work?

What do you think is the most difficult part of sales / customer service work?

Imagine you have been on your feet and working hard all day. A customer you are assisting is rude and impatient, what do you do?

List the name, relationship, number of years acquainted, and phone number of three references. (No relatives please).

Reference 1
Reference Name:
Relationship:
Years Acquainted:
Phone Number:

Reference 2
Reference Name:
Relationship:
Years Acquainted:
Phone Number:

Reference 3
Reference Name:
Relationship:
Years Acquainted:
Phone Number:

I certify that all the information I have provided is true, complete and correct.

I authorize you and your organization to investigate all statements contained on this application. I understand that any misrepresentation or omission of facts called for is cause for immediate disqualification and/or if employed, immediate dismissal.

Furthermore, I understand and agree that if employed, I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same rights to terminate my employment at any time, with or without prior notice, except as may be required by law. This application does not in any way constitute an agreement or contract for employment.

I understand that if I am hired, I will be required to provide proof of identity and legal authority to work in Canada.

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