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Christian Horizons
Christian Horizons Career Opportunities
On-Line Application
Date
Last Name First Name Middle
Street Address Home Phone
City Province Postal Code How long at present address?
Position Applying For Preferred Location
Employment Type Full-time    Part-time    Temporary/Relief    Co-op/Other
Previously employed by Christian Horizons? Yes, Date(s)     NoDate Available for work
List any relatives or friends working for Christian Horizons or serving on its Board of Directors
Name    Relationship
Name    Relationship
EDUCATION - Please complete any applicable sections of the following chart
Course of Study / Years CompletedDid you Graduate?Diploma / Degree
High School     Yes    No
Trade/Business School     Yes    No
College or University     Yes    No
Graduate School     Yes    No
Have you worked in the developmental services field? Yes    No   If yes, Type:    How long?
Social Services Experience (Describe any and all qualifications)
Have you been convicted of a criminal offence for which a pardon has not been granted? Yes    No
(A conviction record will not necessarily be a bar to employment.)
If yes, please describe in full detail below
Are you 18 years of age or more? Yes    No
Are you legally eligible to work in Canada? Yes    No
WORK EXPERIENCE - List Present and Former Employers for the last 10 years beginning with the most recent
Name and Address
of Company
Supervisor Describe Your Work Last Wages Date
Started
Date
Left
Reason For
Leaving
$
$
$
$
Why do you wish to work for Christian Horizons?
As part of its evaluation of my suitability for employment, I authorize Christian Horizons to contact my former employers or personal individuals
for references Yes    No
EMPLOYMENT AND PERSONAL REFERENCES
Name / Address of Reference Telephone Years Known
Employment - Name    Address
Employment - Name    Address
Personal - Name          Address
Personal - Name          Address
Attach Your Resume
APPLICANT'S CERTIFICATION - Please read carefully.
Yes, I certify that, to the best of my knowledge, the answers given by me to the foregoing questions and the statements made by me in this application are correct and complete. I understand that misrepresentation or omission of facts in this application may lead to my discharge.
Signature:    ________________________________________

(Signature will be obtained during interview)