OPPORTUNITIES —

CANADA SAFEWAY
APPLICATION FOR EMPLOYMENT

Social Insurance -
Number CTT] CET (CT)

PERSONAL INFORMATION

Name . a Phone 2

fast first middle Apply for job as: .
Present Full Time 0;
address Pan Time vt
no. & street city province postal Student Tr
le

Other name under which you have worked

Are you

presently employeu ——~_— Date of avaitability Referred by
Have you ever worked if so,

for Sateway before? _ where? --
Are you presently : If so, at

attending school? Catt eve}?
Are you under 15? ——___—_______——._ Position applied for

Have you ever been convicted

ofa criminal offense related

to ine position applied tor and

tor which you have not been Are you legally entitled
pardoned? to work in Canada?

AVAILABILITY

SATUPDAY

EMPLOYMENT BACKGROUND
List your PRESENT OR LAST position FIRST.

DATE COMPANY TEETH E NOT NAME AND REASON FOR
MONTH 8 YEAR NAME & ADDRESS INCLUDING | POSITION OF LEAVING

PHYSICAL INFORMATION

Oo you have any physical handicaps or health conditions which woutd limit the performance of duties in the position(s) for
which you have applied? YES! ; NOL: Wyes tist: _ - ~

READ THE FOLLOWING CAREFULLY, THEN SIGN AND DATE THE APPLICATION
IGERTIFY THAT ALL ANSWERS GIVEN BY ME ON THIS APPLICATION ARE TAUE. CORRECT AND COMPLETE TO THE BEST
OF MY KNOWLEDGE. | AGREE THAT. IF HIRED MY CONTINUED EMPLOYMENT BY CANADA SAFEWAY LIMITED OR ITS
AFFILIATES OR SUBSIDIARIES MAY BE CONTINGENT UPON ACCURACY OF THAT INFORMATION IF EMPLOYED, | FURTHER
AGREE WITH THE POLICIES, RULES AND REGULATIONS OF THE COMPANY

| HEREBY AUTHORIZE CANADA SAFEWAY LIMITED. SUBSIDIARIES OR AFFILIATES TO MAKE A PERSONAL INVESTIGATION
OF ME AS DEE MED NECESSARY. SUCH INVESTIGATION SHALL SE WITHIN LIMITS ESTABLISHED BY LAW IN THE PROVINCE
IN WHICH ! AM TO BE EMPLOYED

Signature at Applicant Date

SAFEWAY
NOW HIRING |

if you are available to work

e DAYS e EVENINGS
e WEEKENDS»

¢ Up to 20 hrs. a week asa
General Clerk or Cashier
starting at $8.00 per hour or
up to 40 hrs. a week as a

Service Clerk starting at
$7.00 per hour.

e Student hours available.

DROP THIS
APPLICATION
OFF AT YOUR

LOCAL SAFEWAY

SAFEWAY

Canada Safeway Limited |

Re eee