Online Application1. Personal InformationPosition or Type of Work Applied for:Date MM slash DD slash YYYY SINName First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email Home PhoneCell PhoneDesired Employment Full-Time Part-Time Casual TemporaryCheck off which shifts you are available to work Morning Afternoon Evening Awake Nights Sleep NightsValid B.C Class 5 Driver’s License Yes NoDo you have your own transportation? Yes NoAre you prepared to work 4 hour to 14 hour shifts? Yes NoAre you willing to work overtime? Yes NoFirst Aid Level:Date First Aid Expires MM slash DD slash YYYY Are you a Canadian Citizen or Landed Immigrant? Yes NoIf “No”, what is your status?Have you any disability or medical restriction that may affect your ability to perform the job (s) applied for? Yes NoHave you ever been convicted of a criminal offence? Yes NoDo you have a valid Class 5, B.C. Drivers License? Yes No2. Education and Training2.1 Last Secondary/ High School:NameLocationCourse/Programme, Major Field, etc.Did You Graduate? Yes NoDiploma/Degree AttainedYear Graduated2.2 Vocational School:NameLocationCourse/Programme, Major Field, etc.Did You Graduate? Yes NoDiploma/Degree AttainedYear Graduated2.3 University/College:NameLocationCourse/Programme, Major Field, etc.Did You Graduate? Yes NoDiploma/Degree AttainedYear Graduated2.4 Post Graduate:NameLocationCourse/Programme, Major Field, etc.Did You Graduate? Yes NoDiploma/Degree AttainedYear Graduated2.5 Other Certificates, Licences, Apprenticeship, programmes, or additional related courses:NameLocationCourse/Programme, Major Field, etc.Did You Graduate? Yes NoDiploma/Degree AttainedYear Graduated3. Office SkillsTyping Speed (wpm):Computer Skills: PC MacWord Processing Packages:Spreadsheet/Other Software:Other Skills:4, EMPLOYMENT HISTORY:(begin with your present or most recent position)4.1 Job DescriptionDate From MM slash DD slash YYYY Date To MM slash DD slash YYYY Company NameAddressPosition HeldDuties PreformedPermission to contact your direct supervisor/manager at this employer? Yes NoSupervisor/Manager’s name for reference purposes:Position:PhoneReason for leaving4.2 Job DescriptionDate From MM slash DD slash YYYY Date To MM slash DD slash YYYY Company NameAddressPosition HeldDuties PreformedPermission to contact your direct supervisor/manager at this employer? Yes NoIf no, please explain.Supervisor/Manager’s name for reference purposes:PhoneReason for leaving4.2 Job DescriptionDate From MM slash DD slash YYYY Date To MM slash DD slash YYYY Company NameAddressPosition HeldDuties PreformedPermission to contact your direct supervisor/manager at this employer? Yes NoIf no, please explain.Supervisor/Manager’s name for reference purposes:PhoneReason for leaving5. General InformationFREEDOM OF INFORMATION/PROTECTION OF PRIVACY:Pertaining to employment history, career objectives or relevant interests and experience. (Completion of this section is very helpful in assisting us to assess your qualifications) In addition, the spaces below can be used to highlight any additional information which you feel is directly related to the position for which you are applying.READ CAREFULLY BEFORE SIGNING/AGREEINGI certify, agree and understand that all information supplied on this application is true and I understand that any untrue statements will be grounds for termination of my employment at any time during my employment. In connection with this application, I authorize all organizations, companies, persons, educational institutions, law enforcement agencies, government departments, current and former employers to release information they have about me and release them from any liability from doing so. I accept the purpose of the information gathering is to determine my suitability for employment. I further understand that appointment is dependent upon: (a) Successful completion of a probationary period, if applicable, (b) Passing applicable testing, where required, (c) My ability to pass a medical examination, where required, (d) Contacting my previous employers to obtain satisfactory reference checks. yes NoDJ Hildebrandt Homes Inc © 20111-2323 Hunter Road | Kelowna, BC V1X 7C5 (250) 717-1887 | (250) 717-1883 (fax) administration@hildebrandthomes.com