Employment Application

OAK MARITIME (CANADA) INC

* Mandatory Fields - Please Complete

Referece No :

You are applying for work at OAK MARITIME CANADA INC :

Yes No

Applying for : Kitchen Helper Cook Cleanerr Labour

Other ? :

Your Details

Gender :

Male Female

Contact Phone

Date of birth * :

Right to work in Canada * Not Inadmissible Yes No

How many days can you work each week? 5/7 days 3/4 days

Can you join immediately? Yes No

Have you worked for us before? Yes No

If yes specify Post held

Emergency contact / Next of Kin

We collect this information to assess your suitability for employment, to establish your identity, and to create your Oak Maritime (Canada) Inc employment record. It will be kept confidential and not usedfor any other purpose without your permission, except as required by law.

Have you been convicted of a criminal offence in the last 10 years *

Yes No

Do you have any medical condition that might affect fellow workers or food safety *

Yes No

Do you have any allergies? (For example to bees, fruit, pollen, dust, nuts or chemicals) *

Yes No

Do you have any chronic pain, such as back pain or shoulder pain, or any other medical condition that may get worse with hard or repetitive physical work? *

Yes No

Do you take any medications that may affect performance or place you or others at risk? *

Yes No

For the purposes of supporting you in an emergency, do you have any medical condition which we should know about? (Such as diabetes, heart problems, epilepsy etc.) *

Yes No

Do you now, or have you ever had a worker’s compensation claim against any employer? *

Yes No

Date	Employer	Injury	Period of absence	Insurer

It is a condition of employment that the company may conduct health monitoring programs including drug and alcohol testing. Do you agree to participate in health monitoring programs authorized by the company? *

Yes No

Do you have a current driver’s license? Yes No

Licenses, permits, certificates (e.g. Forklift License, First Aid Certificate)

Skill or Qualification	Where Obtained	Type or level

Work History

Position	Company	Length of time

References

Name	Company	Phone

What is your e-mail address? *

Application Date

Document 1 :

Document 2 :

Document 3 :

Document 4 :

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OAK MARITIME

Employment Application

OAK MARITIME (CANADA) INC

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