OFFER PACKAGE & ONBOARDING CHECKLIST

PLEASE COMPLETE & RETURN THE FOLLOWING (Within 5 Business Days):

Signed copy of your Offer Letter

Home Office New Hire Form

Work Permit Forms (if applicable)

Complete any background verifications online via Sterling eConsent (secure link to be
provided)

FIRST DAY CHECKLIST:

Direct Deposit Banking Information* (from your Financial Institution - required to be in your
name)

Provincial & Federal Tax Credit Forms*

* To be completed via Dayforce Self Service. Login details are provided on your first day.
 New Hire Form

Your Personal Information:

Prefix / Title:

*First Name: *Last Name:

*Legal Name as it appears on your Social Insurance (SIN) Card
Preferred Name:
Date of Birth (M/D/Y): Gender:
Marital Status: Single Married Common-Law Other
Preferred Language: English French
SIN #: - - SIN Expiry Date (if applicable):
Address:
Apt: City: Prov: Postal Code:
Home Phone: E-mail Address:
Other Phone: Mobile Business Other:
Comments:

Emergency Contact Information:

First Name: Last Name:

Relationship: Phone: Phone #2:

Direct Deposit:
On your first day, please be prepared to enter your direct deposit banking information (from your
Financial Institution) and your tax information into our Self-Service Payroll System (Dayforce).
Upon your start you will receive a system email notification with login information.

Condition of Employment (for Part-Time Associates):

Please read the following condition of employment and sign your initials below to acknowledge
and agree to the condition:
Currently at Staples, Part-Time (PT) associates are paid their vacation pay entitlement bi-weekly,
however you may request to receive your vacation pay during your scheduled vacation time (talk
to your manager for the PT vacation accrual request form).
 New Hire Form (Continued)

Privacy Statement:

The personal information that you have provided above has been collected by Staples
for the sole purpose of administering our Programs and Policies related to your
employment. From time to time, we retain third party service providers to assist in the
administration and your personal information may be passed to or housed with a third
party in or outside Canada. All third parties with access to personal information are
held to strict confidentiality standards to ensure that your information remains private
and confidential and to ensure that your personal information is only used in the
course of administering our Programs and Policies related to your employment. Please
review our Privacy Policy for more information.

I confirm that I have read and understood the foregoing Privacy Statement and confirm
that the information collected above is accurate.

_____________________________ _____________________________
Associate Signature Date

To Be Completed By Internal Office:

Referred Source: Retail Flow-Through: Y N

Referring Associate:
Start Date: _______________
Business Unit: Dept. Code:
Manager Name: ID:
Manager Title:
Job Code: _______ Title:
Employment Status: Permanent Temporary
Full Time Part Time
Standard Hours (37.5 hours/week)
Salary Administration Plan: __________ Grade: ______
did you know?
We’ve been helping our We have over
customers – entrepreneurs,
educators, students and
parents for nearly store locations We deliver to
85%
30 YEARS There are close to
of Canadians next
day for free, on

1,000
orders over $45.

Staples Corporate Office

We inspire in Richmond Hill, ON
people unique jobs with employs over
to work endless possibilities
smarter, at Staples.
learn more talented associates.
We have close to and grow
10,000 associates every day.
across Canada. 80% 15of minutes
Canadians are located within
of a Staples store.

We’re transforming Staples Canada to The Working and Learning Company – a

company that’s committed to being a dynamic, inspiring partner for all
our customers.
Welcome to the new world of work. Welcome to the new Staples Canada.
We look forward to working, learning and growing with you.

10
 EXTENDED HEALTH CARE FOR FULL-TIME ASSOCIATES 2022
Benefit Plan A Plan B Plan C Plan D
Overall deductible $5,000 None None None

Overall, out of pocket

None None None None
maximum
Prescription Drugs

Deductible Yes None None None

Reimbursement
80% 80% 90% 100 %
(Generic)
Reimbursement
65% 65% 75% 85%
(Brand)

Out of pocket
None None $2,000 $1,500
maximum

Dispensing Fee Cap $11.99 $11.99 $11.99 $11.99

Formulary Prescription Prescription Prescription Prescription

Reimbursement None 70% 80% 90%

Chiropractor,
Naturopath, Massage
Therapist, Speech
Therapist, Osteopath,
$500 combined per $1,000 combined per $1,200 combined
Paramedical Services

Physiotherapist, None
benefit year benefit year per benefit year
Podiatrist/
Chiropodist,
Acupuncturist,
Audiologist, Dietician

Mental Health
Practitioners: Clinical
Counsellor, Marriage
$2,000 per benefit
and Family Therapist, $1,200 per benefit plan $1,500 per benefit plan
None plan year,
Psychoanalyst, Social year, combined year, combined
combined
Worker,
Psychotherapist,
Psychologist

Reimbursement None 100% 100% 100%

Vision

Eye exams None 1 every 24 months 1 every 24 months 1 every 24 months

Glasses and contact $350 every 24

None $150 every 24 months $250 every 24 months
lenses months
 Benefit Plan A Plan B Plan C Plan D
60-day trip at 100% 60-day trip at 100%
60-day trip at 100% co- 60-day trip at 100% co-
Emergency Out-of- co- insurance; co- insurance;
insurance; $5,000,000 insurance; $5,000,000
Province/Canada $5,000,000 lifetime $5,000,000 lifetime
lifetime maximum lifetime maximum
maximum maximum
Hospital None Private ($175/day) Private ($175/day) Private ($200/day)
Hearing aids None $400/60 months $400/60 months $400/60 months
Private Duty
Other

None $10,000/36 months $10,000/36 months $10,000 / 36 months

Nursing
70% 80% 90%
Foot appliances None
$350 every 2 years $400 every 2 years $500 every 2 years
$15,000 lifetime $15,000 lifetime $15,000 lifetime
Fertility Drugs None
maximum maximum maximum
$15,000 lifetime $15,000 lifetime $15,000 lifetime
Gender Affirmation None
maximum maximum maximum
Termination At retirement At retirement At retirement At retirement
Premiums

Single: $20.10 Single: $49.08

Bi-Weekly Taxable cash to you: Single Parent: $40.20 Single Parent: $98.16
Free
Premiums (pre-tax) $10.85 Couple: $40.20 Couple: $98.16
Family: $68.62 Family: $116.73

DENTAL CARE FOR FULL-TIME ASSOCIATES 2022

Benefit Plan A Plan B Plan C Plan D
Deductible None None None None
Basic: 70% Basic: 80% Basic: 90%
Preventative: 70% Preventative: 80% Preventative: 90%
Reimbursement None
Major: None Major: 50% Major: 50%
Orthodontics: None Orthodontics: None Orthodontics: 50%
Basic maximum
Dental Coverage

unlimited
Basic maximum
Major restorative
unlimited
$1,000 combined maximum $1,500 per
Maximums None Major restorative
basic and preventative year
maximum $1,000 per
Ortho maximum $2,000
year
lifetime for adults and
children
Orthodontic coverage N/A N/A N/A Adults & Children
Recall Exams None Once every 6 months Once every 6 months Once every 6 months
Scaling None 8 units per year 8 units per year 8 units per year
Dental fee guide None Current Current Current
Termination At retirement At retirement At retirement At retirement
Premiums

Single: $10.27 Single: $26.78

Bi-Weekly Premiums Taxable cash to you: Single Parent: $20.54 Single Parent: $53.57
Free
(pre-tax) $6.00 Couple: $20.54 Couple: $53.57
Family: $28.62 Family: $68.90