Cuddy Farms Employment Application
Personal Information			Date
Name
	Last		First		Middle
Present Address
		Street		City	Prov.	Postal Code
Permanent Address
		Street		City	Prov.	Postal Code
Phone
Are You Related to Anyone In Our Employ?				Yes	No	If yes, who?
Have You Ever Been Employed By Cuddy Farms?					Yes	No
If yes, where?			Who was your supervisor?
Were you referred by an employee of Cuddy Farms?						Yes No
If yes, please give employee's name.
At Your Place Of Residence, Is There Poultry, Pet Birds, or Pigs?						Yes No
Are you legally entitled to work in Canada?						Yes No
Employment Desired			Full-time		Part-time		Summer
Position			Start Date			Salary
Have you ever been convicted of a criminal offence for which you have not been pardoned? Yes No
Employment History
Former Employers		List Below, Starting With Last One First
Employer					Dates	Salary	Position Held
Name					From
Address							Reason For Leaving
City Prov. P.C.					To
Phone #		Contact Person
Employer					Dates	Salary	Position Held
Name					From
Address							Reason For Leaving
City Prov. P.C.					To
Phone #		Contact Person
Employer					Dates	Salary	Position Held
Name					From
Address							Reason For Leaving
City Prov. P.C.					To
Phone #		Contact Person
Employer					Dates	Salary	Position Held
Name					From
Address