Calgary Edmonton Regina Saskatoon Vancouver Winnipeg
     
Name:

 Age: (If under 18 years):

 
Present Address:
Postal Code:
How Long?
Previous Address: (If present address < one year)
 Postal Code:
 Telephone:
Emergency Contact:

    
Address:
 Postal Code:
 Telephone:
Applying For:   Preferred Location:  
Full Time Part Time  
Have you been previously interviewed by DOMO? Hours Available:  
Yes No  
Have you been previously employed by DOMO? If yes give location, dates and name of supervisor:
Yes No  
Education  
School Attended:
 Grade Completed:
  
School Attended:
 Grade Completed:
  
Employment Record      
Name of Company:

Type of Work:
Location & Rate of Pay:

Date Started:

 Date Left:
Supervisor:
 Reason For Leaving:
       
Name of Company:

Type of Work:
Location & Rate of Pay:

Date Started:

 Date Left:
Supervisor:
 Reason For Leaving:
References      

Name:

 Where They Can Be Contacted:

Name:

 Where They Can Be Contacted:
Have you ever been convicted of a criminal offence related to the position applied for and for which you have not been pardoned?
Yes No
I understand that misrepresentation in any of the above statements will result in the cancellation of this application, and if I am employed will be cause for dismissal. Employment with this company is contingent upon the applicant's acceptance by a Bonding Company for a Fidelity Bond. This is at the company's expense. In connection with my application for employment herein, I consent that DOMO Gasoline Corporation Ltd. may conduct and/or cause to be conducted a personal investigation. DOMO Gasoline Corporation Ltd. will not require any notice of termination for their hourly paid employees; by the same token DOMO Gasoline Corporation Ltd. will not give any prior notice to those employees they wish to terminate.
Yes No