Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Phone *

(###)

###

####

Work Status *

(If employed, documentation must be submitted.)

Canadian Citizen

Permanent Resident

Work Visa

Student Visa

Are you able to travel to Mississauga or Brampton for work? *

Yes

No

Do you have your security licence? *

Yes

No

Are you CPR Certified? *

Yes

No

Do you have a Canadian Driver License? *

Yes

No

Do you have access to a personal vehicle? *

Yes

No

Do you have a Use of Force Certificate? *

Yes

No

Do you have a Smart Serve Certificate? *

Yes

No

What type of work you are interested in: *

(May choose more than one.)

Full Time

Part Time

On Call / Pick Up Shifts

Are you comfortable standing for long hours and lifting up to 50 lbs? *

Yes

No

What is your regular shirt size? *

Small

Medium

Large

X-Large

XX-Large

Other

Do you have a Criminal Record? *

Yes

No

Do you consent to a Criminal Background Check / Interpol Criminal Record Check? *

Yes

No

Preferred Contact Date *

MM

DD

YYYY