Employment Application

 Dalton Chemical Laboratories Inc. is an equal opportunity employer. We pledge
 non-discrimination in our employment practices and have developed the following
 recruitment procedures:

     · Applications are completed and accepted in our Human Resources Department
       Monday through Friday during posted hours.

     · Applications will be retained in our active file for six months. During that time,
       should an applicant's credentials meet the requirements of a position and it is our
       desire to meet with that applicant, we will make contact by telephone or mail.

     · All candidates for a position will be screened by the Human Resources
       Department. If a candidate passes our initial screening, he or she will be referred
       to the hiring supervisor for an interview.

    

All Fields Are Required.

APPLICANT INFORMATION

First Name:

 

Home Telephone:

Middle Name:

Work Telephone:

Last Name:

Email Address:

Address:

 

 

City:

  May we telephone you at work?

Yes     No

Prov/State:

Are you legally eligible to work in Canada?

Yes     No

Postal Code:

Are you between 18 and 65 years of age?

Yes     No

 

Position applied for:

How did you learn of this opening?

Rate of Pay Expected:

Do you know anyone employed at Dalton?

Date Available:

Do you have a reliable means of transportation?

WORK EXPERIENCE

1.                  Position:

Dates Of Employment:

Employer:

Address:

Supervisor:

Telephone:

Beginning Pay:

Ending Pay:

Reason For Leaving:

Responsibilities:

May we contact this employer?     Yes     No

 

2.                  Position:

Dates Of Employment:

Employer:

Address:

Supervisor:

Telephone:

Beginning Pay:

Ending Pay:

Reason For Leaving:

Responsibilities:

May we contact this employer?     Yes     No

 

3.                  Position:

Dates Of Employment:

Employer:

Address:

Supervisor:

Telephone:

Beginning Pay:

Ending Pay:

Reason For Leaving:

Responsibilities:

May we contact this employer?     Yes     No

 

Please attach your resume:

 

Authorization
I certify that the forgoing information is correct and complete. I understand that Dalton Chemical Laboratories Inc. may terminate my employment because of falsification of statements, answers or materials omissions made by me in this employment application. I authorize Dalton Chemical Laboratories Inc. to investigate these statements, references, previous employers, school records and authorize the release of such information without liability to its representatives.  

  Yes, I authorize the above.

  No, I do not authorize the above information.