Employment Application

    Name: (Last, First, Middle)

    P.O. Box:   
    Telephone No.:

    Email:
    Street Address:
    National Insurance No.:
    Date of Birth:
    Age:

    MALEFEMALE

    Height:
    Weight:
    Place of Birth:

    Check One:
    SingleMarriedWidowedSeparatedDivorced

    Number of Dependents:
    Children
    Relatives
    Others
    Spouse’s Name:
    Spouse’s Occupation:
    Position desired:
    Salary requested: $
    In case of emergency, notify:
    Name:
    Address:
    Telephone:
    When are you available:
     
    Do you have a valid driver’s license? YesNo
    Do you own a car? YesNo
    If yes, give:
    Make:   Model:   Year:   Island:   Number:
    Has your driver’s license ever been suspended? YesNo
    If yes, why?
    Have you any physical limitations that would affect your performance on the job? YesNo
    If yes, explain:
    Religion: CatholicAnglicanBaptistMethodistOther

    EDUCATION:
    High School -
    QUALIFICATIONS:
    Technical School -
    College -
    Other -

    RECORD OF PREVIOUS EMPLOYMENT

    Most Recent Employment

    Total length of service

    From Month/Year to Month/Year
      
    Total Time Employed
    Name & address of employer

    Name:
    Address:
    Supervisor:
    Type of work
    Reason for leaving
    Avg weekly earnings

    Previous Employment

    Total length of service

    From Month/Year to Month/Year
      
    Total Time Employed
    Name & address of employer

    Name:
    Address:
    Supervisor:
    Type of work
    Reason for leaving
    Avg weekly earnings

    Previous Employment

    Total length of service

    From Month/Year to Month/Year
      
    Total Time Employed
    Name & address of employer

    Name:
    Address:
    Supervisor:
    Type of work
    Reason for leaving
    Avg weekly earnings

    I UNDERSTAND AND AGREE THAT FOR THE FIRST 12 WEEKS OF EMPLOYMENT I WILL BE ON PROBATION. AT ANY TIME DURING THIS 12 WEEK PERIOD I CAN LEAVE THE EMPLOY OF THE COMPANY OR THE COMPANY CAN DISPENSE WITH MY SERVICES AND NO NOTICE OR PAYMENT IN LIEU OF NOTICE IS REQUIRED BY EITHER SIDE. IF I AM DISMISSED DURING THE 12 WEEK PROBATIONARY PERIOD, I WILL BE ENTITLED TO REMUNERATION ONLY FOR THE ACTUAL PERIOD WORKED.

    Signature of applicant:
    Date:

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