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Minter Country Garden Ltd. 10015 Young Road North Chilliwack, BC V2P 4V4 Ph: 604 792-6612 Fax: 604 792-8893 Email: [email protected]

52892 Bunker Rd., Rosedale, BC PO Box 40, Chilliwack BC, V2P 6H7 Ph: 604 792-3799 Fax: 604 792-8893 Email: [email protected]

Application for Employment Date of Application: Have you ever applied with us before?

Yes:_____

No:_____

Have you ever worked with us before?

Yes:_____

No:_____

Part 1 - General Information: Last Name: ____________________

First Name: __________________

Middle Initial: _____

Address: Street: ________________________________________________________________________ City: ___________________________________ Phone: __________________

Province: ______

Cell: _____________________

Postal Code: __________

Email: ___________________

Employment Status: Are you legally eligible to accept employment in Canada?

Yes: _____ No: ______

Note: documentation of proof may be required

When are you able to start work?

___________________

Salary Expected: _____________

Part 2 - Preferred Location: Please select your preferred work location in order of preference (#1 indicates first choice, #2 second, etc.)

Country Garden Ltd (Chilliwack) Retail:_____ Nursery:_____ Floral:_____ Café:_____ Seasonal Plants:_____ Greenhouse:_____ Custodial:_____ Minter Gardens (Rosedale) Grounds:_____ Gift Shop:_____

Restaurant:_____

Do Not Write Below This Line – Office Use Only:

Kitchen:_____

Office:_____

Custodial:_____

Part 3 - Position Sought and Why? Position Title:___________________

Full Time: _____

Part Time: _____

Summer Only: _____

Year Round: _____

Other (please specify): Part 4 - Education: High School or Equivalent Post Secondary Institutions (begin with most recent)

Level Attained: ______________________ Faculty, Department, Division or School

Discipline or Major

Degree, Diploma or Certificate

Date of Completion

Part 5 - Special Skills: Highlight any personal, interpersonal, special experience, training or other skills you possess that would be relevant to the position(s) sought:

Part 6 - Work Experience: Please describe your last three work experiences (paid or unpaid) starting with the most recent. If you have a more extensive work history, please attach your resume to this form. Position: ___________________________ City: _______________________

Name of Organization: _______________________

Province: ____

Start/End Dates: ___________________

Duties and Responsibilities: ________________________________________________________ ______________________________________________________________________________ Reason for leaving: ______________________________________________________________ Type of Work: Summer: ___

Full-Time: ___

Part-Time (No. of hrs/week): ________

Volunteer: ___

Internship/Co-op: ___

Other (please specify): ______________

Reference Name: _________________________________

Position: ___________________________ City: _______________________

Phone #: ___________________

Name of Organization: _______________________

Province: ____

Start/End Dates: ___________________

Duties and Responsibilities: ________________________________________________________ ______________________________________________________________________________ Reason for leaving: ______________________________________________________________ Type of Work: Summer: ___

Full-Time: ___

Part-Time (No. of hrs/week): ________

Volunteer: ___

Internship/Co-op: ___

Other (please specify): ______________

Reference Name: _________________________________

Position: ___________________________ City: _______________________

Phone #: ___________________

Name of Organization: _______________________

Province: ____

Start/End Dates: ___________________

Duties and Responsibilities: ________________________________________________________ ______________________________________________________________________________ Reason for leaving: ______________________________________________________________ Type of Work: Summer: ___

Full-Time: ___

Part-Time (No. of hrs/week): ________

Volunteer: ___

Internship/Co-op: ___

Other (please specify): ______________

Reference Name: _________________________________

Phone #: ___________________

Part 7 - Extra-Curricular Activities: Please describe activities such as volunteer work, membership in organizations, leadership roles, sports activities, hobbies, etc. that you take part in.

Part 8 - Personal References: Please provide the names of three persons, not related to you, that have known you for at least one year. Name:

Address:

Phone:

Years Known:

PLEASE READ CAREFULLY: APPLICANT’S CERTIFICATION AND AGREEMENT Please make sure all questions have been answered completely and accurately.  I authorize investigation of all statements contained in this application, including the contact of work and personal references by Minter.  I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge. I understand that if employed, falsified statements on this application shall be considered sufficient cause for dismissal. Signature of Applicant: _________________________________ Date: __________________

Thank you for completing this application form and for your interest in employment with us. We would like to assure you that your opportunity for employment with us will be based only on merit, skills and abilities, and no other considerations. Due to the great number of applications we receive each year, only those selected for an interview will be contacted. Thank you for your understanding.

Please note that all of Minter Country Garden Ltd. and Minter Gardens’ facilities are NON-SMOKING.