Employment Application Form

Complete this employment application form to apply online. If you prefer, you can print and deliver or fax a paper version.

    * fields are required


    First Name *

    Last Name *

    Apartment/Unit #

    Street Address *

    City *

    Province *

    Postal Code *

    Phone 1 *

    Phone 2

    E-mail Address *


    Position(s) applied for: *

    Are you age 18 or older:

    Are you legally entitled to work in Canada?

    Upon employment we will request your Social Insurance Number (“SIN”) and/or any government document that can confirm your SIN or eligibility to work in Canada.


    Highest level of education completed: *

    School/Institute: *

    Additional License(s) and/or Certificates:


    Position 1 *

    Company 1 *

    Start Date 1 *

    End Date 1 *

    Position 2

    Company 2

    Start Date 2

    End Date 2

    Position 3

    Company 3

    Start Date 3

    End Date 3

    Please identify the kind of employment you are interested in:

    Please identify shifts you are available to work: *

    What date are you available to start work?


    Please provide three employment related references, including your current supervisor (if applicable).

    Name and Title 1: *

    Employment Relationship 1: *

    Company, Phone Number, Email 1: *

    Name and Title 2:

    Employment Relationship 2:

    Company, Phone Number, Email 2:

    Name and Title 3:

    Employment Relationship 3:

    Company, Phone Number, Email 3:


    All information provided in this form, supporting resume and/or cover letter is considered confidential as defined by the BC Personal Information Protection Act “PIPA”). Haro Park Centre will only use this information to manage the application and selection of candidates for employment. You consent and authorize Haro Park Centre to contact the references provided for the purposes of considering your application for employment. You understand that information obtained from your references is provided to Haro Park Centre in confidence and will not be disclosed to you. Falsification of this information or omission of any pertinent information during the selection process may disqualify your employment. Applicants agree to undergo, as needed: criminal record check, drivers license abstract review, provincial license/credential verification; pre-placement health assessment and TB screening, which are relevant to jobs at Haro Park Centre.