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Application Form

Gender
Shift
Safety Boots
Transportation

List any physical limitations relative to the job (Heart conditions, problems with arms, legs wrists hand or back muscles, disc, tendons or joints). This may limit your ability to do heavy manual work, repetitive work or work with machinery and production equipment:

EMERGENCY CONTACT INFORMATION

CAN WE EMAIL YOUR PAY STUBS & T4 INSTEAD FOR PRINT?

EDUCATION

WORK HISTORY

Employment 1
Employment 2

Make sentences with the following words

Evaluate the following:

WHMIS + WORKPLACE SAFETY

The purpose of MSDS is to:






The purpose of the WHMIS label is to:






If the worksite you are sent to requests you work on any duty with hazardous product, you should:






Write the WHMIS symbol letter (A to H) beside the definition that best describe the symbol

proactivesolutions
Compressed Gas
Corrosive Material
Oxidizing Materials
Poisonous and Infectious Materials
Biohazardous Infectious Materials
Material Causing other Toxic Effects
Reactive Material
Flammable and Combustible Material
Complete the Worker Health and Safety Awareness in 4 Steps and upload your certificate https://www.labour.gov.on.ca/english/hs/elearn/worker/foursteps.php
Go to Step 4

PLEASE READ CAREFULLY - APPLICANTS CERTIFICATION AND AGREEMENT

GENERAL AND SAFETY RULES AND REGULATIONS (This must be thoroughly read and signed.)

WORKHOURS

Because these are temporary assignments, YOU ARE RESPONSIBLE to confirm with you supervisor. foreperson. if you are needed to return to work the next day, as well as the time you are needed for.

We MUST be advised of ANY TIME OFF.

IT IS THE EMPLOYEES RESPONSIBILITY TO SUBMIT TIME SHEETS SIGNED BY THE SUPERVISOR. IF THIS 1S NOT DONE OR YOU FAIL TO PUNCH YOUR CARD, YOUR PAY WILL BE DELAYED UNTIL YOUR TIME SHEET IS RECEIVED.

  1. Employee are expected to work and conduct themselves in a safe and orderly manner at all times.
  2. Closed in STEEL TOE SHOES/BOOTS (Green Patch C.S A.)MUST be worn at all times. Under NO conditions may sandals or other open type footwear be worn. GLOVES, SAFETY GLASSES AND EAR PLUGS are very good safety tools. If you have these items please advise us. If not, they are to be supplied by the company you are assigned to if required.
  3. No temporary employee is permitted to ride on any lft truck or pallet truck, or to operate any MECHANICAL EQUIPMENT unless it has been APPROVED by the department of supervisor.
  4. All employees are required to inspect any machinery/equipment for suitability and safety prior to using. Report any defects to a supervisor immediately.
  5. Regular warehouse type clothing must be wom. Fad clothing such as feathers, long strings or streamers, scarves and excessive jewelry is not acceptable. NO SHORTS OR MUSCLE SHIRTS ALLOWED AT ANY TIME.
  6. LIFTING use your legs, not your back, Stack materials neatly to prevent them from sliding off and striking you or from cutting you with sharp edges.
  7. Running in a plant or warehouse is an unsafe act and is therefore prohibited. POWER TOOLS OR MACHINERY are not to be operated without written permission
  8. Any form of fighting or horseplay in the warehouse or on company property is cause for immediate dismissal.
  9. Entering or being on our customers premises while under the influence of or carrying, or consuming any alcoholic beverage or any narcotics is subject toIMMEDIATE DISMISSAL
  10. JOB RELATED HAZARDS (WHMIS) please ask the supervisor about the company’s regulation upon first reporting to any assignment.
  11. OPENING CASES OR REMOVING ITEMS FROM CASES you are handling is cause for immediate dismissal and possible prosecution resulting in a criminal record.
  12. Leaving our customer's premises before the end of your regular work shift without notifying your supervisor or We are providing him/her with sufficient reason, is subject to IMMEDIATE DISMISSAL.
  13. It is possible you may be placed with a company which deals with high value merchandise, and as such the customer may inspect you bags or purses daily.
  14. ALL ACCIDENTS MUST BE REPORTED to your supervisor, so that an incident can be made out by your supervisor.
  15. If you are injured, you understand that we have modified work available and that you must contact the branch office immediately.

I have read and understand the HEALTH & SAFETY EMPLOYEE HANDBOOK and am aware of my responsibility under these policies. I understand that I can ask the manager or the Occupational

health and Safety Representative for further explanation should it be required.I also understand that it is my responsibility to report any unsafe condition, incident or injury immediately.

I certify that I have viewed the Safety video explaining WHMIS. I understand that I can ask the client to whom I am assigned about any hazardous materials I may be handling at the job site and request their training should it be require I hereby certify that the facts set forth in the above employment application are true and complete to be the best of my knowledge.

I understand that if employed, falsified statements on this application shall be considered sufficient cause for dismissal, and that I will comply with the above rules and regulations.

I ,provide permission to photocopy my social Insurance Card and any other documentation which may contain my birth date and/or a photographic image of myself.

Social Insurance Number
Photo ID (NO Health card)
Current Status:
Status Document

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