Confidential Employment Form

All information in this form is kept confidential and is for office use and other legally permissible reasons. If you experience any difficulties completing this form, please request a paper version.

I. PERSONAL INFORMATION

Name

First Name

Last Name

Middle Name

Phone

(###)

###

####

Street Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Date of Birth

MM

DD

YYYY

Social Insurance Number

Start Day

MM

DD

YYYY

Bank Information

Please provide this information so we can deposit your salary. You can find this information on a void cheque, your bank app on your phone, or a Direct Deposit Form from your bank.

Transit Number

Institution Number

Account Number

II. CONTACT IN CASE OF EMERGENCY

Name

First Name

Last Name

Relationship

Phone Number

(###)

###

####

III. EMERGENCY MEDICAL INFORMATION

Allergies

Medications

IV. GENERAL INFORMATION

Position

Received Orientation and reviewed Employee Handbook?

Yes

No