PERSONAL INFORMATION

Last Name:

Given Names:

Address:

Telephone (Home)

 

Postal Code:

Telephone (Work)

Date of Birth:

Sex:           M___________        F___________

EMail Address:

Height:

Weight:

Eye Colour:

Hair Colour:

Physical and/or Medical Conditions/Restrictions:

 

 

 

 

 

 

 

 

 

 

EDUCATION, CREDENTIALS, INVOLVEMENTS

Secondary School

Highest grade or level completed

Type of Graduation Diploma

Post Secondary

Name of Program

Length of Program

License, Certificate, Diploma, or Degree awarded

               Yes                             No

Details

Post Secondary

Name of Program

Length of Program

License, Certificate, Diploma, or Degree awarded

               Yes                             No

Details

List any Work Related Skills:

List any other Hobbies, Qualifications, which are applicable to this position:

 

 

 

 

 

REFERENCES: (excluding personal friends and relatives)

NAME and OCCUPATION

ADDRESS

TELEPHONE

 

 

Home

Work

 

 

Home

Work

 

 

Home

Work

 

 

Home

Work

EMPLOYEMENT

PRESENT EMPLOYER:

 

ADDRESS

TELEPHONE

FAX

DOES YOUR EMPLOYER AGREE WITH YOU JOINING THE SEARCH & RESCUE TEAM?

                     YES                  NO  

                     

AUTHORIZED SIGNATURE OF EMPLOYER:

SIGNATURE:                                                 

PLEASE PRINT:

DATE:

 

 

 

 

 

 

 

 

AUTHORIZATION FOR POLICE CHECK

 

I AUTHORIZE THE GEORGIAN BAY VOLUNTEER SEARCH AND RESCUE EXECUTIVES TO REQUEST THE POLICE TO CHECK THEIR RECORDS ON ME, AND TO RELEASE SUCH INFORMATION TO THESE EXECUTIVES. ALL INFORMATION WILL REMAIN CONFIDENTIAL.

 

SIGNATURE:                                                                                                   DATE:

 

 

 

 

 

 

PLEASE WRITE A BRIEF DESCRIPTION WHY YOU WOULD LIKE TO JOIN THE GEORGIAN BAY VOLUNTEER SEARCH AND RESCUE TEAM; AND WHAT ARE YOUR EXPECTATIONS?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I HEREBY DECLARE THAT THE FOREGOING INFORMATION IS TRUE AND COMPLETE. I UNDERSTAND THAT A FALSE STATEMENT MAY DISQUALIFY ME FROM MEMBERSHIP WITH THE GEORGIAN BAY VOLUNTEER SEARCH AND RESCUE OR RESULT IN DISMISSAL. IT IS UNDERSTOOD AND ACCEPTED THAT I AM INVOLVED IN A COMPETITIVE RECRUITMENT SELECTION PROCESS AND THAT MY OFFER FOR MEMBERSHIP MAY BE DECLINED AT ANY PROCESSING STAGE. I ALSO UNDERSTAND THAT THE OPPORTUNITY FOR MEMBERSHIP WITH THE GEORGIAN BAY VOLUNTEER SEARCH AND RESCUE WILL BE BASED SOLELY ON MERIT AND ON NO OTHER CONSIDERATIONS.

APPLICANT SIGNATURE:

DATE:

 

 

 

 

 

RETURN APPLICATION TO:

 

GEORGIAN BAY VOLUNTEER SEARCH AND RESCUE

P.O. BOX 5002

PENETANGUISHENE, ONTARIO, L9M 2G2

APPLICATION 2003-09