UsitechNov - Design Précision Innovation

PERSONAL DATA
*Last name:
*First name:
*Address:
*City:
*Province:
*Country:
*Postal Code/Zip:
*Telephone:
*Email:

Position of interest :
Requested salary :
Availability date :
Availability: Full Time
Part Timel
Summer
Temorary
Practical Training
Daytime
Evening
Weekend

Are you a student ?

Yes No

Are you legally entitled to work in Canada?

Yes No

Do you know anyone currently working for us (friend or relative)?

 Yes No
If yes, please give their name(s):

Proficiency in French:

 Spoken: Excellent Average Poor
Written : Excellent Average Poor

Proficiency in English:

 Spoken: Excellent Average Poor
Written : Excellent Average Poor

Proficiency in other language(s):

 Spoken: Excellent Average Poor
Written : Excellent Average Poor

EDUCATION
Highest grade completed Name of course or main subject matter Degree/Diploma/Certificate/License
High School :
Apprenticeship:
Technical and college::
University:

COMPLEMENTARY PROFESSIONAL TRAINING

Name of course
Duration of course
Dates

TECHNICAL APTITUDES
What office equipment and software do you know how to use?
What machines, tools (measuring tape, vernier), vehicles can you operate?

WORK EXPERIENCE
Employer name and address


Start date End date 		Job title and duties


Reason for leaving

Previous salary
Employer name and address


Start date End date 		Job title and duties


Reason for leaving

Previous salary
Employer name and address


Start date End date 		Job title and duties


Reason for leaving

Previous salary
Employer name and address


Start date End date 		Job title and duties


Reason for leaving

Previous salary

ADDITIONAL INFORMATION
Do you have a valid Driver's license?
Yes No
If yes, state class:

Additional information to support your application:

I am aware that Usitechnov carries a heavy responsibility for the security of its company and that of its employees and that they must take all necessary measures in order to attain this.  I therefore, by the present, authorize Usitechnov to verify the information provided in my application or on my request for an application, more specifically that which pertains to my competence, honesty, integrity and behaviour as well as the direct or indirect reasons for cessation of former employment.  I hereby authorize them to verify any of my judiciary antecedents.  To meet the company's requirements towards the health and safety of its employees I agree to take the company's medical examination.

The information thus obtained may be used solely for the purpose for which it was requested. Verification and enquiries may be carried out by Usitechnov or any other mandated person, within the respect of my right to privacy.

In submitting the present employment application, I acknowledge that any intentional omission of information or false declaration on my part regarding this application can result in dismissal from the company.