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Date*

Name (full)*

E-mail*

Cell*

Medical Card Number

Social Insurance Number

Availability

City/town*

Address*

Postal code*

Salary desired

Are you a Canadian citizen?

Yes
No

If you are not a Canadien citizen, do you have a work permit?

Yes
No

Have you ever been convicted of a crime?

Yes
No

If yes, please explain*

Have you ever worked in the field of security?

Yes
No

If yes, when?*

Available Evenings/Weekends?

Yes
No

Education

Name of University

Period of studies

Did you receive a diploma?

Yes
No

Diploma title

Complementary Studies

References

Please list 3 references

Name

Relationship

Name of company

Address

Name

Relationship

Name of company

Telephone

Address

Name

Relationship

Name of company

Telephone

Address

Previous Employer

Name of company

Telephone

Address

Reason for leaving

Can we contact your previous employer?

Oui
Non

Responsabilities

Final Salary

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I certify that my answers are accurate and honest. Any false or erroneous information indicated on this form or during my interview may result in my dismissal.

Verification

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I do not agree

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Information

References

Previous Employer

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CL Innovations : SME technological Integration in Quebec