Name *

First Name

Last Name

Cell Phone *

(###)

###

####

Home Phone

(###)

###

####

Do You Own A Car *

Yes

No

Gender

Male

Female

Prefer Not To Answer

Are You A Student? *

Yes

No

Previous Experience *

Warehouse

Forklift

Assembly

Order Picker

Machine Operation

Shipping/Receiving

Inventory

Packaging

Power Tools

Woodworking

Painting

What Shift Can You Do? *

Day

Afternoon

Night

Acknowledgement and Agreement *

I acknowledge that I have watched and I understand the WHMIS 2015 video.

I acknowledge that I have read and understand the JustLabour Temporary Help Handbook.

I acknowledge that I have read and understand the Worker Health and Safety Awareness Booklet.