Burger Inn Online Employment Application

To ensure a timely response, please fill in as much information as possible in the form below.

Fields noted by an '*' are mandatory and must be filled for your application to be processed.

Personal Information:

                            *Last Name:

                            *First Name:   Middle Initial:

         Social Insurance Number: - -

                        *Date of Birth : Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

                                *Address:

                                  Address:

                                      *City:   *Province:   

                         *Postal Code :                     *Telephone: - -

                                *Are you legally entitled to work in Canada?  Choose Yes No

                    *Have you ever been convicted of a criminal offence? Choose Yes No If yes, please explain:

              *Any health problems that could affect your employment? Choose Yes No If yes, please explain:

               *Please choose the Burger Inn location you would like to work at: Burger Inn 4th Street Sw Burger Inn Macleod Trail SW Burger Inn Bow Trail SW

Availability:

           *What type of position are you seeking? Part Time  Full Time  Seasonal  Temporary

                            *Date available to start work: Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2005 2004

                            *Hours Available: Sun- Any Time AM-Lunch PM-Dinner Mon- Any Time AM-Lunch PM-Dinner Tue- Any Time AM-Lunch PM-Dinner Wed- Any Time AM-Lunch PM-Dinner

                                                       Thur- Any Time AM-Lunch PM-Dinner     Fri- Any Time AM-Lunch PM-Dinner Sat- Any Time AM-Lunch PM-Dinner

Most Recent Employment:

                                Company:       Location:    Telephone:

                                   Position:    Supervisor:    Salary:

                Dates worked from: to:   Reason for leaving:

                                Company:       Location:    Telephone:

                                   Position:    Supervisor:    Salary:

                Dates worked from: to:   Reason for leaving:

References:

                                    Name:  Relationship: Years Known:

                                            Telephone:

                                    Name:  Relationship: Years Known:

                                            Telephone:

I hereby certify that the information contained in this application is correct and complete to the best of my knowledge, and I understand that giving incomplete or false information is grounds for dismissal. I hereby acknowledge notification that Burger Inn may request information regarding my previous employment and personal history from the references listed, or any other source.

*Yes No