Applicant's Information

Required fields are marked (*)

• Name (*)
  Please enter your name
• Date (*)
  Please enter today's date
• Address
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• City
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• Province
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• Home Phone (*)
  Please enter your home phone number
  (Use this format: xxx-xxx-xxxx)
• Work Phone
  Please enter a work phone number
  (Use this format: xxx-xxx-xxxx)
• Postal Code
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• What position are you applying for?

• HousekeepingVolunteerKitchenOfficeCookMaintenanceRecreationOther
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• What shifts are you available for?

• DaysEveningsNightsWeekends
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• When do you prefer to work?

• Full TimePart TimeCasual
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• General Information

• What is the minimum pay that you would expect? (*)
• Please specify your minimum pay requirement
• Have you previously worked for the Lacombe Foundation?YesNo
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• If YES, please indicate dates of employment from:
• to
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• LocationLacombe Lodge - LacombeCameron Manor - LacombeParkview Manor - LacombeSpruce Terrace - LacombeCommunity Housing - LacombeLakeview Manor - AlixOxford Court - BentleyTower Manor - BlackfaldsEckville Manor - EckvilleGolden Villas - EckvilleLamerton Place - Mirror
• Manager
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• Do you have any relatives working for the Lacombe Foundation?YesNo
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• If YES, please indicate
• and Relationship
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• Do you have reliable transportation to and from work?YesNo
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• Basic First Aid
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• Date
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• WHMIS
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• Date
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• CPR
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• Date
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• Food Handlers
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• Date
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• Employment History

• Employer One

• Dates:
• From (*)
  Please enter the employed from date
• To (*)
  Please enter the employed to date
• Position (*)
  Please specify your position
• Company (*)
  Please name the company
• Address (*)
  Please specify the address
• Type of Business (*)
  Please specify the business type
• Supervisor (*)
  Please provide your supervisors name
• Phone Number (*)
  Please enter the employer's phone number
  (Use this format: xxx-xxx-xxxx)
• Salary (*) Hour
  Please specify your salary
• Reason for Leaving: (*)
  Please specify your reason for leaving
• Duties and Experience: (*)
  Please specify your duties and experience
• May we contact this employer for a reference? (*)YesNo
  Please let us know if we can contact your previous employer for a reference

• Employer Two

• Dates:
• From
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• To
  Please enter the employed to date
• Position
  Please specify your position
• Company
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• Address
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• Type of Business
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• Supervisor
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• Phone Number
  Please enter your employer's phone number
  (Use this format: xxx-xxx-xxxx)
• Salary Hour
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• Reason for Leaving:
  Invalid Input
• Duties and Experience:
  Invalid Input
• May we contact this employer for a reference?YesNo
  Invalid Input

• Employer Three

• Dates:
• From
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• To
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• Position
  Please specify your position
• Company
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• Address
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• Type of Business
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• Supervisor
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• Phone Number
  Please enter your employer's phone number
  (Use this format: xxx-xxx-xxxx)
• Salary Hour
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• Reason for Leaving:
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• Duties and Experience:
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• May we contact this employer for a reference?YesNo
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• Education

• Date
• Grade, Degree, Program
• Institution / Location
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• Invalid Input
• Invalid Input
• Invalid Input
• Invalid Input
• Invalid Input
• Invalid Input
• Invalid Input
• Invalid Input

• Additional training, courses, skills:
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• References: Work related preferred

• Name
• Relationship
• Phone Number
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• Invalid Input
• (Use this format: xxx-xxx-xxxx)
• Invalid Input
• Invalid Input
• Invalid Input
  (Use this format: xxx-xxx-xxxx)
• Invalid Input
• Invalid Input
• Invalid Input
  (Use this format: xxx-xxx-xxxx)

• Additional comments:
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• Application Form Spam Prevention

• Refresh the CAPTCHA
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• I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge. I understand that if employed, any falsified statements on this application shall be considered sufficient cause for dismissal.

• Applicant's Signature (*)
  Please sign the employment application form
• Date (*)
  Please enter today's date

• Provincial legislation requires “that every successful applicant for employment and every new volunteer provide a criminal records check.” This is the responsibility of the applicant but note that the check must be current and therefore will not be required until the applicant has passed the Foundation screening process. The criminal record check results will be considered when offering employment.

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