Application For Employment Personal Information
Last Name:
..............................tian......................................................
Middle Initial: .............................................. First Name:
................wen.................................................... Address:
.......22 Clovercrest Rd.......................................................................................
City:
................................Toronto...............................................................................................................................
Province:
....ON.........................................................................................
Postal Code: ..............M2J 1Z6.................................. Home Phone #:
....................6479842668........................................ Alternate Telephone
#: .................................................................. E-mail:
.......tianwen670723@gmail.com.............................................................................
Have you worked at Wal-Mart before: † No † Yes If yes,
which store: ......................... If yes, note dates:
........................................................ Is there
someone you would like to refer for a position at Wal-Mart? Name:
...................................................................................................
Contact Information:
..............................................................................................................................
Position Position applying for: .......† Seasonal /Temporary
...........................................
Are you interested in: † Full Time (Min. of 28 hrs per week) † Peak Time
(Less than 28 hrs per week) How did you learn about this opportunity?
.. I've been a salesengineer in a factory automation control company. .. Availability Date available to start (dd/mm/yyyy):
....................any time ............ .............................
Indicate when you are available to be scheduled (specify a.m. or p.m.). Due to
the nature of our business, the more available you are, the more opportunities
we can consider you for. Saturday Sunday Monday Tuesday Wednesday Thursday
Friday From To Overnight yes/no
Education Tell us the highest or equivalent
level completed Institution Type Completion Type of Certifi
cation/Diploma/Degree Received High School Year Completed † 1 † 2 † 3 † 4 † 5 Post Secondary † 1 † 2 † 3
† 4 † 5 Employment History Current/Last Position Title:
............................................................................................................................
Company Name: ..........................................................
Company Address:
...........................................................................................................................................................................................................................................
Responsibilities:
................................................................................................................................................................................................................................................
Date of Employment:
.......................................................................................................................................
Reason for leaving: .....................................................
Supervisors Name:
............................................................................................................................................
Position Title:
................................................................ May we contact
them? † Yes † No Supervisors Contact Number:
....................................................................................................................................
Current/Last Position Title:
............................................................................................................................
Company Name: ..........................................................
Company Address:
...........................................................................................................................................................................................................................................
Responsibilities:
................................................................................................................................................................................................................................................
Date of Employment:
.......................................................................................................................................
Reason for leaving: .....................................................
Supervisors Name:
............................................................................................................................................
Position Title:
................................................................ May we contact
them? † Yes † No Supervisors Contact Number:
....................................................................................................................................
I certify that the information on this application is correct and I understand
that any misrepresentation or omission of any information will result in my
disqualifi cation from consideration for employment or if employed my dismissal
for just cause. Wal-Mart Canada Corp may verify the information set forth on
this application and obtain additional background information relating to my
background. I authorize all persons, schools, companies, corporations, credit
bureaus and law enforcement agencies to supply all information concerning my
background. On the fi rst day of employment I agree to provide Wal-Mart Canada
Corp. proof of my age (as required for company benefi t plans and similar
administration), Social Insurance Number and appropriate credentials as may be
required. I understand that the fi rst 3 months of active service will be
probationary during which time my employment may be terminated without notice
of termination of employment or pay in lieu thereof. Candidate’s name (Please
print):
.........wen tian .......... Candidate Signature:
..................................................................................................................................................
Date:
.May 25, 2015.......................................................................
Feel free to attach a resume to this application form Date of Application:
............................................. WMP24CB Rev. 08/09
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