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Mission Statement
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President's Message
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The SecureWorld Way
ABOUT
SERVICES
WHAT WE DO
CAREERS
CONTACT
PERSONAL INFORMATION
*
mandatory field
First Name
*
Last Name
*
Middle Initials
Social Insurance
Present Address
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Postal Code
Permanent Address
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Postal Code
Country
*
Telephone
*
Cell
Pager
Email
*
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Is there any information we would need about your name or use of another name to enable us to check your work record? Please specify:
Do you have any relatives who are presently (or formerly been) employed by SecureWorld Corp.?
How are you referred to SecureWorld Corp.?
Have you ever been convicted of a criminal offence? Yes
No
If yes, please explain:
Are you bondable? Yes
No
EDUCATION
High School
Address
Year Completed
2016
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College
Address
Year Completed
2016
2015
2014
2013
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2009
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Technical Training
Address
Year Completed
2016
2015
2014
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Other
Address
Year Completed
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
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EMPLOYMENT RECORD
Company Name
*
Company Name
Company Name
Position Held
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Position Held
Position Held
Company Address
*
Company Address
Company Address
Telephone Number
*
Telephone Number
Telephone Number
Manager / Supervisor Name
*
Manager / Supervisor Name
Manager / Supervisor Nam
Employed From: To:
*
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
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1987
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1984
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1981
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1967
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1965
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1963
1962
1961
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
2015
2014
2013
2012
2011
2010
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1969
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1967
1966
1965
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1962
1961
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Employed From: To:
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
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1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
2015
2014
2013
2012
2011
2010
2009
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2007
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2003
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1999
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1995
1994
1993
1992
1991
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1989
1988
1987
1986
1985
1984
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1979
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1973
1972
1971
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1969
1968
1967
1966
1965
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1963
1962
1961
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Employed From To
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Wage / Salary
*
$
Wage / Salary
$
Wage / Salary
$
Reason for leaving
*
Reason for leaving
Reason for leaving
REFERENCES
Name
Name
Name
Years Known
Years Known
Years Known
Address
Address
Address
Telephone
Telephone
Telephone
Occupation
Occupation
Occupation
WORK AVAILABILITY
When would you be available to begin work?
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January
February
March
April
May
June
July
August
September
October
November
December
Part Time
Full Time
Do you drive?
Yes
No
Do you have any objection to working overtime?
Yes
No
Can you work overtime without prior notice?
Yes
No
Can you work on weekends?
Yes
No
Can you travel if required by this position?
Yes
No
If your application receives favorable consideration,
What salary / hourly rate would you require? Hour
Year
$
BACKGROUND CHECK AND RELEASE OF INFORMATION AND RESEARCH
Please read this section carefully and acknowledge your understanding by signing your name in the space provided below. 1.Consent to Conduct Background Investigation As a condition of and in regard for SecureWorld Corp. consideration of this application, I authorize SecureWorld Corp. to investigate my personal and employment history. I understand that this background investigation will include, but will not be limited to, verification of all information on this application, as well as interviews with past employers. I further authorize SecureWorld Corp. to conduct this investigation and to discuss the results of this investigation in connection with my application for employment. 2. Consent to Contact Past Employers I authorize SecureWorld Corp. to contact all employers listed in this application (except those specifically excluded) for reference purposes. I further authorize all current or previous employers and/supervisors to discuss my relevant personal and employment history with SecureWorld Corp., I consent to the release of such information orally or in writing and hereby release them from all liability and agree not to take legal action for defamation or other claims based upon any statements they make to any representative of SecureWorld Corp. 3. Consent to Contact Government Agencies I authorize any agent, attorney or representative of SecureWorld Corp. to receive a copy of any information obtained in the file of any federal, provincial or local court, governmental agency, law enforcement agency or investigator concerning or relating to me. I further consent to the release of such information and waive any right under provincial law concerning notification of the request of a release of such information. In the event a provincial Law does not provide for prospective employers to have access to information, I hereby delegate SecureWorld Corp. as my agent for receipt of information. I understand that the scope of this investigation will be limited to criminal and/or civil records that relate to my honesty, integrity and/or liabilities. 4. Cooperation With Investigation I agree to fully cooperate in SecureWorld Corp. background investigation and to sign any waivers or releases that may be necessary to obtain access to relevant information. In the event that any former employer or federal, provincial or local governmental agency will not release reference information or criminal history information directly to the employer. I agree to personally request such information to the extent permitted by law. 5. Falsification Statement I understand that my falsification or willful omission of facts made in this application or in connection with any background investigation may be sufficient grounds for rejection of this application, or if discovered after an offer of employment, is grounds for immediate dismissal. 6. Employment At Will In consideration of my employment, I agree to conform to the rules and regulations of SecureWorld Corp. and my employment and compensation is at will in that they can be terminated with or without cause, and with or without notice at any time, at the option of either SecureWorld Corp. or myself, except as otherwise provided by the law. I understand that no one, other that the officers of SecureWorld Corp. have the authority to enter into any agreement for employment for any specified period of time or to make any agreement or contact to the foregoing, and that any premises to the contrary will only be relied upon by me if they are in writing and signed by and officer of SecureWorld Corp. I certify that all of the statements made on this application for employment are true, correct and complete to the best of my knowledge.
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