Name*

Address 1

Address 2

City or Town

Province or State

Country

Postal or Zip Code

Driver License No

Phone Number

Email Address*

Would you be willing to relocate to Estevan ?

Education History:

Explain your highest level of education, including where and when you attended the school.

Employment History:

List the last 3 places of employment-include the company’s address, your supervisor, the length of time you worked there, the type of job you did and the reason you left. Start with the most recent:

May we contact the employers listed above ?

If not indicate which one(s) you do not wish us to contact.

Personal References:

Please include their occupation, phone number and your relationship with them.

APPLICANT’S CERTIFICATION AND AGREEMENT - PLEASE READ CAREFULLY

I UNDERSTAND THAT THE INFORMATION ON THIS APPLICATION WILL BE USED AND THAT PRIOR EMPLOYERS WILL BE CONTACTED FOR THE PURPOSE OF INVESTIGATION. The applicant agrees to furnish such additional information and complete such examinations as may be required to complete the employment file. It is agreed and understood that this application for employment in no way obligates the employer to employ the applicant.

It is agreed and understood that if employed , the employee will be on a 3 month probation period during which time he/she may be discharged without recourse. It is also understood that following company policies is a condition of continued employment. This certifies that this application was completed by the applicant, and that all entries on it and the information in it are true and complete to the best of my knowledge.

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge. I understand that if employed, falsified statements on this application shall be considered sufficient cause for dismissal.

I authorize Gilliss Casing Services to contact SGI to obtain a drivers abstract on my Saskatchewan Driver's License noted above.

Initial here to agree to these terms:*

Application Date/Time: