Name and location of school attended (specify institution type, ie high school, university, etc.)
List special language skills, scholarships or other significant activities (exclude information indicative of race, sex, religion, colour or national origin).
Other than relatives, provide three references who have known you for the past five or more years.
Account for the past ten (10) years. Include periods of unemployment, self-employment, schooling or military service. List present (or most recent)
position first. Please include any other name under which such records may appear.
I certify that the answers given by me to the foregoing questions and statements are true and correct without consequential omissions of any kind whatsoever. I agree that the company shall not be liable in any respect if my employment is terminated because of the falsity of statements, answers or omissions made by me in this application. I authorize the companies, schools or persons named above to give any information regarding my employment, credentials or scholastic standing, together with any other information they may have. I understand that supplying false or misleading
information is grounds for immediate dismissal.