School of Physical & Health Education

Queen’s University

EMPLOYMENT APPLICATION FORM

PLEASE PRINT CLEARLY                                                                             

   Date: _____________________________

 

Last Name:  ______________________  First Name: ____________________

 

Please Ö check:        Male                  Female

 

E-MAIL ADDRESS: _____________________________________________________________

 

Kingston Address:  _____________________________________________________________

 

Postal Code:   ____________________    Kingston Phone Number:  (613) _________________

 

Home Address: ________________________________________________________________

 

Postal Code:  ____________________    Home Phone Number:  (        ) ___________________

 

Date of Birth: __________________   Social Insurance Number: __________________

 

Student Number: _____________________ Employee Number: __________________________

 

Have you ever been paid by Queen’s before?          

q       Yes                        If yes, what department _______________________________________

q       No

 

ü       JOB APPLYING FOR:   

    Instructional Sports Skills                      Equipment Service 

    Lifeguard                                             Stadium/Arena

    Security                                              Events Staff

 

        Other: ____________________________________________________

 

Qualifications:     (attach separate sheet if necessary)

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

 

By signing this form, I am aware of the following expectations and conditions for employment in the Physical Education Centre.

1.                    That I will comply with the Queen’s University Harassment/Discrimination Policy, which provides safeguards and complaint procedures for all of its members against any form of harassment or discrimination.  These include harassment and discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, creed, sex, sexual orientation, age, marital status, family status and handicap.

2.                    That I will be punctual for work, dress in an appropriate manner, and represent the School of Physical & Health Education in a positive and professional manner at all times.

 

Signature:   ___________________________________________________   Date: ______________________________

 

**PLEASE PROVIDE TIMES WHICH YOU WILL BE AVAILABLE TO WORK ON THE BACK OF THIS PAGE**