Primary Response Inc.

First name *	Last name *
Home phone *	Work phone	Cell phone	Email *
Street address *		Address line 2
City *	State / Province / Region *	Postal / Zip Code *	Country *

WE ARE CURRENTLY ONLY ACCEPTING APPLICATIONS FROM LICENSED INDIVIDUALS. (IF YOU DO NOT HAVE A LICENSE YOU WILL NEED TO GET ONE FROM THE MINISTRY BEFORE FILLING OUT AN APPLICATION)

Are you currently licensed as a Security Guard within the Province of Ontario? *

Security License Number *

Expiry Date *

Have you previously worked with Primary Response? *	If yes, indicate when?	Have you previously submitted an application to Primary Response? *	If yes, indicate when?

Are you currently working for another security company or working as an in-house security guard or bouncer? *	If yes, what company?	Our company policy states you cannot work for another security company while working for Primary Response. Are you willing to abide by this condition of employment? *	Immigration Regulations - To be legally entitled to work in Canada, you must be a Canadian citizen, a landed immigrant or have a valid work permit. Are you legally entitled to work in Canada? *

Have you ever been convicted or found guilty of an offence under the law of any country, state, province or territory, for which a pardon has not been granted, or are there any proceedings or charges now pending? (An ABSOLUTE DISCHARGE or a CONDITIONAL DISCHARGE is a finding of guilt.) *

Starting with the most recent job you had, please fill in the fields for the past 5 years. Please include the following for all previous employers: any application submitted without all these details will not be considered!

PAST EMPLOYER 1
Company Name *	Company Address *	Company Phone Number *	Supervisors Name *

Position *	Start Date *	End Date*	Reason for leaving *

Wage *	Reference *



PAST EMPLOYER 2
Company Name *	Company Address *	Company Phone Number *	Supervisors Name *

Position *	Start Date *	End Date*	Reason for leaving *

Wage *	Reference *



PAST EMPLOYER 3
		Reference



PAST EMPLOYER 4
		Reference



PAST EMPLOYER 5
		Reference




PERSONAL REFERENCES List 4 persons other than a relative whom you have known for at least 5 years. Please include a name, address, phone number and occupation for each reference. Also, please indicate whether or not we can contact each of these references.
Personal Reference 1		Personal Reference 2

Personal Reference 3		Personal Reference 4

Position you are applying for: *	If other, what position? *	Wage Expected (per hour) *

Please indicate which days you are available and which shifts. FULL TIME positions require employees to be available to work any day of the week (Monday to Sunday), for any shift. NIGHTS, AFTERNOONS and NIGHTS. We do not hire people full time for only one type of shift. Full time positions do require employees to be able to work weekends. PART TIME positions require employees to be available every weekend to work any shift. CASUAL positions require the employee to provide a list of shifts or times they are available to work and as shifts open they will be called. THERE IS NO GUARANTEE OF HOURS FOR CASUAL EMPLOYEES. Day shifts are anytime between 06:00 - 19:00 Afternoons shifts are anytime between 14:00 - 23:59 Night shifts are anytime between 22:00 - 08:00

Date Available to Start Work with Primary Response:*	Please Indicate type of work you are looking for: *

Day Availability: Monday Tuesday Wednesday Thursday Friday Saturday Sunday	Afternoon Availability: Monday Tuesday Wednesday Thursday Friday Saturday Sunday	Night Availability: Monday Tuesday Wednesday Thursday Friday Saturday Sunday

I am willing and able to work in the following areas. Please check applicable areas. *
Toronto Scarborough East York Pickering	Etobicoke Mississauga Brampton Peel Region	North York Markham Vaughan Newmarket	York Region Barrie Simcoe Durham

Do you have a valid Ontario Driver's License? *	If yes, what class?	Do you own or have regular access to a vehicle to get back and forth from work? *	If you do not own or have access to a vehicle to get back and forth from work, please indicate how you intend to travel to and from job locations

Please select the highest level of education completed *	Do you have an Ontario Secondary School Diploma (O.S.S.D.)? *	Have you completed a College, University or Technical School Program? *	If yes give details

Have you completed any training courses relative to the security industry? *		If yes give details (Course name, location, dates and instructor)

Are you currently under any contract or non-competition clause? *

Online Application for Employment

1Personal Information

2License Information

3Employment History

4Availability / Schedule Information