Name * First Legal Name

Last Legal Name

Phone *

Email *

Address Street Address

City

State/Region/Province

Postal / Zip Code

Status in Canada? * ARE YOU STUDENT/WORKER/PR?

SIN Number and its expiry? (Optional)

Employment Type?

Availability Days / Timing * MORNING/AFTERNOON/EVENING

How do you travel to work? (Example: Bus or Car) *

Can lift up to? (Example: up to 25lbs; up to 35lbs; up to 50lbs)* LIGHT/MEDIUM/HEAVY?

Do you have work-related licenses (Example: Forklift, Welding, etc.) *

Previous Job Experience? (Insert just titles) *

Accomodations Required? (Example: disabilities, etc)

Resume

I confirm that all the information presented above is correct! *

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