Application Form

Name: ___Zackary Fanning_______________ Date: June 12, 2015__________________

Phone: ___587-435-9600________ Social Insurance Number: ___736-479-197____________
Job/Position Applied for: _____Lawn Maintenance, Strathmore Golf Club_____________
Part-time: _____________ Full-time: ______X___________ Either One: ___________________
Address: _100 Brent Boulevard_______________ Postal Code: ___T1P1V2__________
City or Town: ___Strathmore Alberta______________________________________________
Are you presently employed? ___yes__________ Date of Availability: ________Any________
Are you presently attending school? ____yes____ If so, at what level? ______Grade 12_______
Secondary School Attended? ______SHS_______ Year Graduated? _________2015________
University or College Attended? _____no_______ Year Graduated? _________-------________
List any certificates obtained: ______________________________________________________
Have you ever been convicted of a criminal offense related to the position applied for? ________
Are you under 15? ____no________Are you legally entitled to work in Canada? ____yes_____
Do you have any physical handicaps or health conditions which would limit the performance of
your duties in the position for which you have applied? _________no_____________________
EMPLOYMENT BACKGROUND
Start
Company
Telephone Position
Date
Jan 24 Rona
403-934- Yard
4679
worker
Nov 21 Yards n
403-608- Crew
stuff
4762
man

Starting
Wage
$12/hr

Final
Wage
$13/hr

Date
Left
Nov 20

$14.50/hr 14.50/hr January

14

Reason for
Leaving
Out of seasonnew job
New Job

Are you restricted in the time or amount of hours you can work? _______ Yes __X____ No
Please List any Restrictions: _______________________________________________________
Hours
Available
From
To

Sunday

Monday

Tuesday

Wednesday Thursday

Friday

Saturday

Open
Close

Open
Close

Open
Close

Open
Close

Open
Close

Open
Close

Open
Close

Read the following carefully and then sign the application

I certify that all the answers given by me on this application are true, correct and complete to the best of my
knowledge. I agree that, if hired, my continued employment may be contingent upon accuracy of this information. If
I am employed, I further agree with the policies, rules and regulations of the Company and I will not disclose or
reveal any confidential information related to the company.

Signature of Applicant: ____

2015______

Zackary Fanning__ Date: __June 12,