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Acadian Construction

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671 boul. Malenfant Blvd, Suite 1 Dieppe, New Brunswick Canada, E1A 5T8.

EMPLOYMENT APPLICATION DETAILS / EVALUATION

CRINIMAL OFFENCE:

Have you been convicted of criminal offence? YES / NO

Have you participated in diversion scheme? YES / NO

Do you have any criminal actions pending which could result in a criminal conviction either?
in Canada or Overseas? YES / NO

Are you aware of any pending matter which may affect the status of your current license to practice?
etc (if that license relates to the employment you seek)? YES / NO

If yes to any of the above, please give details…

………………………………………………………………………………………………………………………………………………………………………….

Do you consent to Acadian Construction undertaking a criminal record check?


YES / NO

YOUR ASPIRATIONS / HOBBIES / INTERESTS?......................................................................................................

…………………………………………………………………………………………………………………………………………………………………………….

How did you hear about this position? Acadian Website/Newspaper/SEEK/Trade


Me/Other………………………………….

INTRODUCTION:
Were you introduced to this position by a current Acadian Construction staff member or Specialist?
YES / NO

If Yes, who………………………………………………………………………………………………………………………………………………..

DECLARATION:
I have no objections to Acadian Construction, verifying the statements I have made on this application
form. However, I understand that my present employer will not be contacted without my consent.
I, ....................................................................................... (Full name), declare to the best of my
knowledge the answers in this application are correct and that, if I have supplied a CV, it is accurate
and current. I understand that if any false or deliberately misleading information is given or any
material fact suppressed, I will not be accepted; or if I am employed, such falsification will be treated
as serious misconduct for which the penalty is instant dismissal.

PLEASE NOTE:
If your application is successful, the information you provide on this application will be retained on
your personnel file. You have a right of access to personal information contained on your personnel
file and to seek any correction you think necessary to ensure accuracy.

If your application is unsuccessful do you consent to Acadian Construction retaining the information
contained in this application form for the purposes of considering your suitability for any other
position that may arise within the organization in the future? If yes, the information will be retained
for a period of 12 months for this purpose?
YES / NO

I agree to enquiries being made of the noted referees as to the accuracy of information contained in
this application form, or any other matter relating to my suitability for employment YES / NO

Signature............................................................................

EMPLOYMENT HISTORY:

YOUR CURRENT EMPLOYER

Position Held
Employer
Year: From- To
Area of Work
Reason for Leaving

YOUR NEXT MOST RECENT EMPLOYERS

Position Held
Employer
Year: From- To
Area of Work
Reason for Leaving

REFEREES:
Please give details of referees – recent employers preferred – from whom we can obtain written or
verbal references on your work, background and experience:
(1) ................................................................... (2) ..................................................................

.................................................... ……………….. ......................................................................

....................................................................... ......................................................................

Phone Number........................ ……………………. Phone Number............................................

Email.............................................................. Email...........................................................

APPLICATION FOR EMPLOYMENT:

Important: For us to consider your application you should provide complete information in answer to
each question, regardless of whether you consider it relevant to the position applied for.

POSITION APPLIED FOR……………………………………………………………………………………………………………

PERSONAL DETAILS:

1. NAME.........................................................................................Mr /Mrs / Ms / Miss / Dr


2. HOME ADDRESS:
3. DIRECT MOBILE NUMBER:
4. PASSPORT NUMBER
5. AGE:
6, SEX:
7. MARITAL STATU:

RESIDENT STATUS: Do you have the right of permanent residence in Canada? YES / NO
(Please note: You are required to produce evidence of your eligibility to work in Canada.
please attach copy of your passport)

EDUCATION AND TRAINING


Secondary School Attended...........................................................................................................

Number of Years Attended...................... Highest Qualification Attended.....................................

OTHER QUALIFICATIONS:
Qualification.............................................. Year.................................. Training Centre

…………………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………………

Do you intend to engage in other paid work whilst employed in the position applied for? YES / NO
Are you a member of a territorial force unit or volunteer fire brigade? YES / NO
Are you able to work overtime? YES / NO
If No, why? .................................................................................................................................................
If your application is accepted, hope you will obey instruction and the policy of the company? YES / NO

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