PRINCE ALBERT CATHOLIC SCHOOLS



-388620342900004145280504825118 – 11th Street EastPrince Albert, SK S6V 1A1Phone: 306-953-7500 Fax: 306-763-1723Email: info@pacsd.caWebsite: pacsd.ca00118 – 11th Street EastPrince Albert, SK S6V 1A1Phone: 306-953-7500 Fax: 306-763-1723Email: info@pacsd.caWebsite: pacsd.caSUPPORT STAFFEMPLOYMENT APPLICATION FORMPOSITION DESIRED:? Full-Time? Part-Time? Substitute? Maintenance? Clerical? School Associate? Caretaking? Library Clerk? School Coordinator? Educational Assistant? Other:PERSONAL DATA: (Please Print)Name in Full:Click or tap here to enter text.Present Address:Click or tap here to enter text.Postal Code:Click or tap here to enter text. Click or tap here to enter text.Home Phone:Click or tap here to enter text.Email: Click or tap here to enter text.Cellular:Click or tap here to enter text.Permanent Address:Click or tap here to enter text.Postal Code:Click or tap here to enter text.Click or tap here to enter text.Telephone:Click or tap here to enter text.Date of Birth (mmm/dd/yyyy):Click or tap here to enter text.Language Spoken Other Than English:Click or tap here to enter text.Religion:Click or tap here to enter text.Please Note: Applications that are not offered positions are kept on file for the current school year.EDUCATION:NAME OF SCHOOLLOCATIONCERTIFICATEHELDDATE OF COMPLETIONHigh SchoolClick or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.Technical/Trade SchoolClick or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.UniversityClick or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.OtherClick or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.SKILL:Please supply information regarding your training and qualifications, which you feel, would be relevant to this application. Indicate specific certificates or licenses held, memberships in professional organizations, etc.2095548895Click or tap here to enter text.Click or tap here to enter text.Indicate which of these skills you possess:? Word? Excel? Payroll? Accounts Payable/Receivable? Library? First Aid/CPR? Journeyman Certificate(s): __________________________? Other: ____________________________________EMPLOYMENT HISTORY:Please supply the following information concerning the last three positions you have held. Should you wish to include other employment history, please attach a resume. Begin with your most recent employer.Employer: Click or tap here to enter text.Position Held: Click or tap here to enter text.Address: Click or tap here to enter text.Duties: Click or tap here to enter text.Phone: Click or tap here to enter text.Supervisor: Click or tap here to enter text.Employment Period:From ____________ To _______________Reason for Leaving: Click or tap here to enter text.Employer: Click or tap here to enter text.Position Held: Click or tap here to enter text.Address: Click or tap here to enter text.Duties: Click or tap here to enter text.Phone: Click or tap here to enter text.Supervisor: Click or tap here to enter text.Employment Period:From ____________ To _______________Reason for Leaving: Click or tap here to enter text.Employer: Click or tap here to enter text.Position Held: Click or tap here to enter text.Address: Click or tap here to enter text.Duties: Click or tap here to enter text.Phone: Click or tap here to enter text.Supervisor: Click or tap here to enter text.Employment Period:From ____________ To _______________Reason for Leaving: Click or tap here to enter text.REFERENCES: Please provide THREE references including your Parish Priest.NameAddressTelephoneParishClick or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.*By submitting an application, you are consenting to the contact of all current and past MITMENT TO CATHOLIC SCHOOL DIVISION:I understand that I have made application to gain employment with a Catholic School Division. Should I gain employment, I agree publicly to support the school division’s philosophy and policies, and to maintain a lifestyle and deportment which adheres to the teachings of the Catholic Church.Date (mmm/dd/yyyy): Click or tap to enter a date.Signature: ___________________________If you are submitting your application electronically, please type your First and Last Name and check the Acceptance Checkbox below:? I understand that checking this box constitutes a legal signature.SELF-DECLARATION FORM (Completion of this section is mandatory)The School Division requires the completion of the following information for Saskatchewan Ministry of Education. The self-declaration is optional but completion is mandatory. It will be entered into your personal electronic profile on SRB only if you are hired as an employee to provide a statistical profile of our work force to the Government of Canada. It will remain confidential.?01Not Aboriginal?02Choose Not to Declare?03Treaty / Registered / Status Indian?04Non-Status Indian?05Metis?06Inuit / Inuk-483870516890For Office Use Only:? Yes? NoEmployed by PARCSSD No. 6Which PARCSSD No. 6 School _____________________________________All NEW applicants must include in their application package:? Original Criminal Record check (including vulnerable sector check)? Religious Reference – Parish Priest? A void cheque or banking information form? Acceptable Use of Technology Form? Resume AttachedBargaining Unit:?01 None?04 CUPE00For Office Use Only:? Yes? NoEmployed by PARCSSD No. 6Which PARCSSD No. 6 School _____________________________________All NEW applicants must include in their application package:? Original Criminal Record check (including vulnerable sector check)? Religious Reference – Parish Priest? A void cheque or banking information form? Acceptable Use of Technology Form? Resume AttachedBargaining Unit:?01 None?04 CUPE ................
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