Human Resources
270 18
th
Street
Brandon, MB R7A 6A9
Fax: (204) 726-1957
Email: hr@brandonu.ca
Application for Employment
Resume attached Yes No
Last Name Given Names
Address
Telephone
Email
Position Applied For
Job Vacancy Number
Date Available for Work
Type of Employment Preferred
Full-Time Part-Time
Student Casual
Are you legally entitled to work in Canada? Yes No
To be legally entitled to work in Canada, you must be a Canadian Citizen or Landed Immigrant, obtain a work permit, or have a valid
student authorization.
How did you know about this vacancy Employee Newspaper BU Website Job Bank (HRDC)
Other __________________________________________
Have you ever been employed by Brandon University? Yes No
If yes, please complete the following:
_____________________________ ________/_________ ______/____________
1. Position (most recent) Started: Month/Year Left: Month/Year
___________________________________________ _____________________________________________________________
Department Reason for Leaving
___________________________________________
Supervisor’s Name and Title
_____________________________ ________/_________ ______/____________
2. Position Started: Month/Year Left: Month/Year
___________________________________________ _____________________________________________________________
Department Reason for Leaving
___________________________________________
Supervisor’s Name and Title
EDUCATION / TRAINING
Secondary School Grade 9 10 11 12 13
Check highest year successfully completed.
Vocational School / College / University
Institution Attended
Name & Address of Institution
Highest
Level
Successfully
Completed
Type of Certificate,
Diploma or Degree
Community College
University
Other
Trade Certificate
Type
Province
Class
Expiry Date
Skills and Abilities
C
lerical Skills
basic accounting/booking minute taking customer service handling cash/cash register
Computer Skills
keyboarding _____ wpm word processing spreadsheets database data entry
desktop publishing power point web page design
Technical / Trades / Maintenance Skills
S
pecify ______________________________________________________________________________
_____________________________________________________________________________________
O
ther Skills (specify any other courses or skills that you would bring to this position)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________
________________________________________________________________________
_____________________________________________________________________________________
Employment History
___________________________________________________________________________
_____________________________ ________/_________ ______/____________
Employer Started: Month/Year Left: Month/Year
___________________________________________ _____________________________________________________________
Address Reason for Leaving
____________________________ ___________ _____________________________________________________________
Position Held Salary Main Duties
___________________________________________ _____________________________________________________________
Supervisor’s Name and Title
___________________________________________ _____________________________________________________________
Supervisor’s Work Telephone Number
May we contact this supervisor? Yes No
_____________________________________________________________________________
_____________________________ ________/_________ ______/____________
Employer Started: Month/Year Left: Month/Year
___________________________________________ _____________________________________________________________
Address Reason for Leaving
____________________________ ___________ _____________________________________________________________
Position Held Salary Main Duties
___________________________________________ _____________________________________________________________
Supervisor’s Name and Title
___________________________________________ _____________________________________________________________
Supervisor’s Work Telephone Number
May we contact this supervisor? Yes No
______________________________________________________________________________
_____________________________ ________/_________ ______/____________
Employer Started: Month/Year Left: Month/Year
___________________________________________ _____________________________________________________________
Address Reason for Leaving
____________________________ ___________ _____________________________________________________________
Position Held Salary Main Duties
___________________________________________ _____________________________________________________________
Supervisor’s Name and Title
___________________________________________ _____________________________________________________________
Supervisor’s Work Telephone Number
May we contact this supervisor? Yes No
______________________________________________________________________________
Why do you wish to become an employee of Brandon University and what are your present ambitions?
References
Name
Business
Address
Telephone Number
Type of Reference Employment Personal
Name
Business
Address
Telephone Number
Type of Reference Employment Personal
Name
Business
Address
Telephone Number
Type of Reference Employment Personal
READ CAREFULLY
This personal information is being collected under the authority of the Brandon University Act and will be used for assessing
employment suitability. It is protected by the Protection and Privacy provisions of The Freedom of Information and Protection of
Privacy Act. If you have any questions about the collection, contact the Director, Human Resources, Brandon University, Brandon,
MB R7A 6A9.
1. I understand that my employment with the University may be jeopardized by any false or misleading information given by
me on this form.
2. I authorize the University, or any Agent acting on its behalf, to make whatever inquiries the University deems necessary
concerning any information relating to my past employment and medical history, in consideration of this Application,
(subject to the provisions of The Canadian Human Rights Act, and The Human Rights Act and The Personal Investigations
Act of the Province of Manitoba).
3. I understand that if employed, deductions will be made from my salary for Disability Insurance and Pension Plans when I
become eligible to participate. Furthermore, I understand that, upon reaching age 65, I may not be eligible for coverage
under these plans.
Date
Applicant’s Signature
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signature
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