MR. MRS. MISS
FULL NAME
ADDRESS
CITY POSTAL CODE
PHONE NO    
EMERGENCY CONTACT PHONE NO.
POSITION APPLIED FOR SALARY EXPECTED
SMARTSERVE CERT # DO NOT HAVE CERT
WHAT TYPE OF WORK : TEMPORARY
PART TIME
FULL TIME 		INDICATE AVAILABILITY: DAYS
NIGHTS
WEEKENDS
PREFERABLE LOCATIONS
EMPLOYMENT HISTORY
1 EMPLOYER NAME
ADDRESS
POSITION HELD (DETAILS)
2 EMPLOYER NAME
ADDRESS
POSITION HELD (DETAILS)
3 EMPLOYER NAME
ADDRESS
POSITION HELD (DETAILS)
PLEASE LIST PAST EMPLOYER REFERENCES
1. NAME PHONE NO.
2. NAME PHONE NO.
3. NAME PHONE NO.
I authorize and request each former employer above, to answer any and all questions that may be asked and give any information concerning my work habits, skill or character. I also authorize (upon hiring) that uniform costs can be deducted from my pay cheque if said uniform is required for the position I am hired for and that I will also be responsible for the cost to replace said uniform if it is required due to regular wear and tear. Uniform costs are non-refundable. I also understand and accept that I will be paid bi-weekly and that overtime pay is based on that bi-weekly payroll after 88 (eighty-eight) hours.