Skilled trades application form ON

Personal Information

First Name

Last Name

Date of Birth (DD/MM/YYYY)

SIN

Address

Appt#

City

Province

Postal Code

Cellphone number

Home Phone

Are you legally entitled to work in Canada?

Yes No

Do you require a work permit to work in Canada?

Yes No

If yes, expiry date

Are you at least 18 years of age?

Yes No

Have you been the subject of a conviction for a criminal offense for which a pardon has not been granted?

Yes No

If yes, please give the nature of the offense:

Education and Training

Level of education

Name of institution

Course Name

Year completed

Level of education

Name of institution

Course Name

Year completed

Emergency contact

Full Name

Cell Number

Home Number

Relationship

Desired positions

Desired position(s):

Desired status:

Permanent Temporary Full-Time Part-Time

Means of transportation:

Public Transit Vehicle Other

If other, please specify:

Which following work equipment do you own :

Minimum hourly rate or salary:

Available Start Date:

Employment History

Employment #1

Employer (Company name)

Years (From - To)

Address

Supervisor's name

Position Title

Phone

Employment #2

Employer (company name)

Years (From - To)

Address

Supervisor's name

Position Title

Phone

Physical Demands / analysis

Physical demands / requirements

Standing

Yes No

Sitting

Yes No

Walking

Yes No

Lifting - Moderate I - 11 to 26lbs (5 to 11kg)

Yes No

Lifting - Moderate II - 26 to 40lbs (11 to 18kg)

Yes No

Lifting - Heavy I - 40 to 65lbs (18 to 30kg)

Yes No

Lifting - Heavy II - Greater than 65lbs (30kg)

Yes No

Carrying - 1 to 20lbs (1 to 9kg)

Yes No

Carrying - 21 to 40lbs (10 to 18kg)

Yes No

Pushing - 1 to 40lbs (1 to 9kg)

Yes No

Pushing - 21 to 40lbs (10 to 18kg)

Yes No

Pulling - 1 to 40lbs (1 to 9kg)

Yes No

Pulling - 21 to 40lbs (10 to 18kg)

Yes No

Climbing Ladders / Catwalks

Yes No

Kneeling

Yes No

Repeat Bending

Yes No

Crouching

Yes No

Reaching - Forward

Yes No

Reaching - Overhead

Yes No

Repetitive finger movement

Yes No

Repetitive hand movement

Yes No

Repetitive twisting or pressure of wrist

Yes No

Working conditions

Cold Environments

Yes No

Hot to warm Environments

Yes No

Dusty Environments

Yes No

Dry Atmospheric Conditions

Yes No

Working Alone

Yes No

Other work-related limitations:

Check to confirm

Check to confirm you answered the above to your best knowledge

General Authorization

General Authorisation

By checking the box, you accept the below:

By completing and submitting this application, I authorize Fuze HR Solution Inc or its agent to investigate my background, character, general reputation and prior employment by contacting my prior employers, references or any individuals Fuze HR considers necessary, (understanding that I have the right to request in writing disclosure of certain information obtained by Fuze HR in the course of its investigation of my background and experience).

I authorize Fuze HR, my prior employers, references and any other individual contacted by Fuze HR to release any and all information they may have regarding me and to absolve those parties who provide information requested from any and all liability related to their doing so. I acknowledge that any employment offered to me is at will and may be terminated by Fuze HR at any time, with cause or according to the mandate.

I certify by my signature that this application and all information in it are true and complete to the best of my knowledge and agree that providing false, misleading or incomplete statements in this application or in connection with Fuze HR’s evaluation of me as a candidate for employment is grounds for immediate termination of my employment, regardless of when such information is discovered.

Fuze HR respects your rights to privacy and takes its responsibilities regarding the collection, use and disclosure of your personal information seriously. Fuze HR is subject to the Freedom of Information and Protection of Privacy Act and has made appropriate security arrangements to protect the personal information in its care against such risks as unauthorized access, collection, use, disclosure or disposal.

Fuze HR is collecting your personal information in this application in order to assess your qualifications and suitability as a potential employee of Fuze HR. Fuze HR will not disclose this information to third parties unless it is legally required to do so.

Should you accept employment with Fuze HR, your personal information will be retained throughout your employment and for at least seven years following the termination of your employment for any reason. If you do not immediately obtain employment with Fuze HR, your personal information may be kept in our online database for a maximum of 6 months. You may choose to remove this information at any time.

EXCEEDING LIMITS ON HOURS OF WORK

For work over 48 and under 60 hours per week, by signing below I am entering into an agreement that I accept overtime. The overtime can be greater than 8 hours per day and greater than 48 in a week. I also understand that if I choose not to accept overtime over 48 hours per week that is my choice and I will not sign in that case. I have received a copy of the legislation as well as copy of this signed document (as per the Employment Standards Act section 17 (5) subsection 2 or in clause 3 (a) and 21.1 2004 c21, s, 4.).

I further understand that all hours in excess of 44 are paid at time-and-a-half as per the Employment Standards Act. I also understand that any assignment employee, including myself as well as the employer can cancel this agreement by giving reasonable notice.

Background Checks and Other Payroll Deductions

Accept the terms

By checking the box, you hereby authorize Fuze HR Solutions Inc to make deduction from my wages for the above selected payroll deductions and terms below:

Some of our clients require background verification and other equipment needed to preform your duties at their workplace. Fuze HR makes no profit on these transactions and is only acting as an administrator for our clients. We have negotiated the lowest price possible available to us at this time.

If we do need to performe a background check before sending you to an assignment, fees may apply. The different background checks: Criminal Background Check ($25.00), Credit Check ($15.00), or both ($35.00). The fee(s) will be deducted from your paycheck.

For some assignments, material such as a swipe card may be required. Swipe Card deductions will be reimbursed to you when the materials are returned to Fuze HR or the client upon completion of your assignment. There is no charge for this unless the material is not retuned to Fuze HR upon completion of your assignment.

In signing this form, you agree that IF requested by one of our clients, any charge of the below expenses incurred in verifying your qualifications and/or equipment need for work will be charged back to you. We will inform you prior to doing any verifications or charging you for conducting verifications.

Important information regarding our Payroll Process

This document is important information regarding our payroll process. Fuze HR Solutions is happy to have you join our team and we want to make sure once your employment starts that you receive your pay on a weekly basis with no interruptions (on Fridays throughout the day). The fastest and easiest method of pay is by direct deposit.

All direct deposit information must be provided to our office upon registration. Delay providing direct deposit forms will result late payment until the following pay period once payroll is closed Tuesday of each week.

Important Information: Reimbursement of safety equipment

In order to comply with its obligations under Article 51 of the Health and Safety Act, Fuze HR Solutions has implemented a reimbursement policy for safety equipment. Fuze HR Solutions Inc. is committed to providing our employees with the necessary safety / protection equipment free of charge.

Confirmation of Legislation Compliance Training

Confirmation of completion of following training

By checking this box, the candidate mentioned in part "Personal information" has completed/read the 3 following training materials:

Read: Fuze HR's Policy and Procedure Reference Booklet.PDF
- Occupational Health & Safety Awareness Training OHSA Reg 297/13.
- WHIMIS (Workplace Hazardous Material Information Systems)
- Bill 168 & Bill 132 (Workplace Violence, Harassment & Sexual Harassement)
- AODA (Accessibiliy for Ontarians with Disabilities Act, 2005) - Customer Service Training
- AODA (Accessibiliy for Ontarians with Disabilities Act, 200) - Human Rights Training
- Drug and Alcohol Policy
- Employment Standards Poster entitled "Employment Standards in Ontario", version 9.0
Read: Ministry of Labour: Information for Employees About Hours Work and Overtime
- https://files.ontario.ca/mol-infosheet/employee-rights-temp-help-agency-2019-06-19.pdf
- https://www.ontario.ca/document/your-guide-employment-standards-act-0

Health & Safety Test

For this test, please match the WHMIS 2015 hazard pictogram with the correct category above

1) Flammables (gases, aerosols, liquids, solids); Pyrophoric (liquids, solids, gases); Self- reactive substances and mixtures and mixtures; Self-heating substances and mixtures; Substances and mixtures which, in contact with water, emit flammable gases, organic peroxides.

Choose the correct answers:

1) A signal word on a shipping label:

A) Describes the nature of the hazards of the product B) Alerts the reader quickly to the severity of the chemical's hazard C) Explains how to handle the chemical safety D) Is always accompanied with a pictogram

2) Workplace labels are required when:

A) Products are transferred from its original supplier container into another B) container C) The supplier label is missing or illegible D) The product is produced in the workplace E) All of the above

3) A Safety Data Sheet (SDS) is available in the workplace to:

A) Assist the purchasing department in buying chemical B) Describe workplace policy C) Provide detailed hazard and safety information about a controlled product D) None of the above

4) Which of the following SDS sections describes emergency procedures, protective equipment and how to contain and cleanup a spill or release?

A) First Aid Measures B) Accidental Release Measures C) Handling and Storage D) Exposure Controls/Personal Protection

5) If you are working with a chemical and need to find out about the routes of exposures, as well as the short and long term effects of exposures, where on the SDS would you look?

A) Section 2: Hazard Identification B) Section 8: Exposure Controls / Personal Protection C) Section 11: Toxicological Information D) Section 16: Other Information

6) Manufacturing and suppliers are free to choose how to format information on Canadian MSDSs under WHMIS 1988, so long as the nine basic categories of information are always included.

A) True B) False

7) Under WHMIS 2015, hazardous products are assigned to hazard classes based on their properties

A) True B) False

8) What type of PPE is represented by this symbol?

A) Hat B) Boots C)Gloves D) Goggles

Confirmation of completion "Worker Health and Safety Awareness in 4 Steps"

By Checking this box you have completed the "Worker Health and Safety Awareness in 4 Steps" training.
Click here to start the video training: https://www.labour.gov.on.ca/english/hs/elearn/worker/foursteps.php

Upload certificate from the "Worker Health and Safety Awareness in 4 Steps" training

Skilled trades application form ON

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