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Sears Job Application Form

Applying for a position at a Sears store entails the fulfillment of this form. Accomplished form must be submitted to the manager of the desired site. A successful application is likely to be followed by an interview so applicant should prepare.

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Last 	Name:	First 	Name:	
Address:	
Number	Street	Apt.	No	.	
City	Pro	vince	P	ostal 	Code	
T	elephone:	Home:	(    	)	Cellular	:	(    	)	
Email 	Address:	Business:	(    	)	
Are 	y	ou 	legally 	eligible 	to 	w	or	k 	in 	Canada?		Y	es		No	
(If 	“Y	es”	proof 	required 	upon 	off	er 	of 	emplo	yment)	
Ha	v	e 	y	ou 	e	v	er 	been 	con	victed 	of 	a 	criminal 	off	ence 	for 	which 	a 	pardon 	has 	not 	been 	g	r	anted?		Y	es		No	
Ha	v	e 	y	ou 	e	v	er 	been 	emplo	y	ed 	b	y 	Sears 	Canada 	Inc?		Y	es		No	
If 	‘Y	es’	please 	advise:	Unit:	Star	t 	Date:	Lea	ving 	Date:	
What 	kind 	of 	w	or	k 	are 	y	ou 	interested 	in?:	
Are 	y	ou 	a 	student?		Y	es		No		P	ar	t-time 	Student		Full-time 	Student	
Note:	F	or 	man	y 	positions 	y	ou 	are 	required 	to 	be 	a	v	ailab	le 	f	or 	a 	minimum 	of 	thr	ee 	occasions	per 	week.	Please 	chec	k	
y	our 	a	v	ailability 	belo	w:	
APPLICA	TION 	FOR 	EMPLOYMENT	
Personal 	Data 	(Applicants 	must 	be 	a 	minimum 	of 	16 	y	ears 	of 	age 	to 	apply)	
P	osition 	being 	applied 	f	or	:	W	ould 	you 	accept:	Full 	Time	
P	ar	t	Time	Seasonal	
All 	Days	Mon	T	ues	W	ed	Thurs	Fri	Sat	Sun	
Morning	
Afternoon	
Evening	
Night	
Spoken	W	ritten	
French
English	
Other	
(specify)	
Languages	
T	o 	deter	mine 	y	our 	qualifications 	f	or 	emplo	yment, 	please 	provide 	belo	w 	and 	on 	the 	re	v	erse, 	inf	or	mation 	related 	to 	y	our	
academic 	and 	other 	achie	v	ements 	including 	emplo	yment 	histor	y 	as 	well 	as 	v	oluntar	y 	w	or	k.	
Education 	– 	(Last 	School 	Attended)	
Pub	lic 	School 		High 	School 		College 		University 		Other 		Explain:	
Name 	of 	School	Gr	ade 	completed	Y	ear 	Completed:	
or 	Deg	ree 	Receiv	ed:	Month	Y	ear	
Other 	courses, 	wor	kshops	, 	seminars, 	v	olunteer 	wor	k	Licenses	, 	Cer	tificates, 	Deg	rees	
10811 	REV	. 	06/05

T	ype 	of 	Business	Reason 	for 	lea	ving	
I 	hereb	y 	declare 	that 	the 	inf	or	mation 	contained 	in 	this 	Application 	f	or 	Emplo	yment 	is 	tr	ue 	and 	complete 	to 	my 	kno	wledge	.	
I 	understand 	that 	a 	f	alse 	statement 	ma	y 	disqualify 	me 	from 	emplo	yment, 	or 	ma	y 	cause 	my 	dismissal 	for 	cause	.	
I 	hereb	y 	consent 	to 	the 	collection, 	use 	and 	disclosure 	of 	the 	inf	or	mation 	provided 	in 	this 	Application 	f	or 	Emplo	yment 	f	or	
the 	pur	poses 	of 	v	er	ifying 	an	y 	such 	inf	or	mation 	whether 	to 	hire 	me	.	
I 	hereb	y 	authorize 	Sears 	Canada 	Inc.	(“Sears”) 	and/or 	a 	firm 	retained 	by 	Sears 	to 	use 	and/or 	disclose 	the 	inf	or	mation	
mentioned 	in 	this 	Application 	f	or 	Emplo	yment 	f	or 	the 	pur	poses 	of 	v	erifying 	any 	such 	inf	or	mation,	
I 	hereb	y 	authorize 	Sears 	and/or 	a 	firm 	retained 	b	y 	Sears 	to 	collect 	my 	personal 	inf	or	mation 	and/or 	conduct 	an	y	
in	v	estigation 	rele	v	ant 	to 	m	y 	application 	f	or 	emplo	yment 	f	or 	the 	purposes 	of 	Sears’	deter	mination 	with 	respect 	to 	m	y	
application 	for 	emplo	yment.	
I 	ac	knowledge 	and 	consent 	to 	this 	in	v	estigation 	being 	carr	ied 	out 	b	y 	telephone 	or 	in 	wr	iting 	with 	others 	at 	educational	
institutions	, 	f	or	mer 	emplo	y	ers, 	or 	m	y 	current 	emplo	y	er	, 	who 	are 	all 	hereb	y 	author	iz	ed 	to 	disclose 	the 	inf	or	mation 	to 	Sears	.	
Signature	Date	
Ha	v	e 	y	ou 	attached 	an 	additional 	sheet/resume?		Y	es		No	
W	ork 	Related 	Skills/Pr	evious 	Employment 	(Beginning 	with 	present/last 	employer)	
Name 	and 	Address	of 	pr	esent/last 	emplo	y	er	Present/last 	job 	title	
Name 	of 	Super	visor	
Final 	Salar	y	
P	er	iod 	of 	emplo	yment	
F	rom:	T	o:	
T	elephone	
(      	)	
Ma	y	w	e	approach 	for	ref	erences	?	
	Y	es		No	
Name 	and 	Address 	of 	pr	evious	emplo	y	er	Previous 	job 	title	
Name 	of 	Super	visor	
Final 	Salar	y	
P	er	iod 	of 	emplo	yment	
F	rom:	T	o:	
T	elephone	
(      	)	
M a	y	w	e	a	p	p	ro	a	ch	 f	o r	r e f	e r e n c e s	?	
	Y	es		No	
T	ype 	of 	Business	Reason 	for 	lea	ving	
Duties/Responsibilities
Duties/Responsibilities
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