Online Application

Personal Information

Name *Please enter full name including middle initial

Email Address

Cell Phone *

Home Phone

Social Insurance Number (SIN) *

Street Address *

City *

Province *

Postal Code *

Basic Information

Application Date *

Type of Employment *Full-TimePart-TimeSelect all that apply

Position Applied For *

Expected Monthly Pay Range *

Were you referred by a current PTC Employee? *YesNo

If YES, please provide their name

Have you ever worked for PTC, Paterson Grain or Truck Freight International in the past? *YesNo

If YES, when?

Do you have a valid Driver's License? *YesNo

Have you been involved in any motor vehicle accidents in the last 3 years? *YesNo

If YES, please describe:

Have you been convicted of any traffic violations in the last 3 years? *YesNo

If YES, please describe:

Do you have a valid Class 1 Driver's License? *YesNo

License Number

Issuing Province

Employment History

Begin with your present / current employer and work backwards in order, listing all of your employers, training programs, periods of military service, self-employment and unemployment for the last 5 years. All time must be accounted for.

From Date *

To Date *

Position Held *

Employer *

Supervisor's Name *

Location *

Phone Number

Average Monthly Earnings *

Email Address

Reason for Leaving *

Period of Unemployment prior (if any)

From Date

To Date

Position Held

Employer

Supervisor's Name

Location

Phone Number

Average Monthly Earnings

Email Address

Reason for Leaving

Period of Unemployment prior (if any)

From Date

To Date

Position Held

Employer

Supervisor's Name

Location

Phone Number

Average Monthly Earnings

Email Address

Reason for Leaving

Period of Unemployment prior (if any)

From Date

To Date

Position Held

Employer

Supervisor's Name

Location

Phone Number

Average Monthly Earnings

Email Address

Reason for Leaving

Period of Unemployment prior (if any)

Job Requirement Information

All positions at PTC include the following job duties:

Working a rotation of up to 10 days on / 4 days off, working 10-12 hours per day, as required
Travelling within Manitoba, Saskatchewan, and Alberta
Working at heights
Working in a variety of conditions (wet, muddy, dry, dusty, hot, cold, rain, snow,etc)
Working at physically demanding jobs which may require and is not limited to:
Carrying heavy objects (lifting up to 23 Kg unassisted)
Bending to pick-up tools or material, pour cement, make or strip cement forms, or other common tasks to a construction site
Hammering using standard tools such as a claw or sledgehammer
Kneeling for extended periods of time
Reaching while doing tasks such as iron work or load placement using cranes
Climbing stairs and ladders
Shoveling dirt, sand, or mud
Working with a variety of hand & power tools
Working around heavy equipment
Working in trenches 1.2 – 8 meters deep
Working in confined spaces

Are you safely able to physically perform the above job duties? *YesNo

If you answered NO, please explain

All positions at PTC are Safety Critical positions. Accordingly, PTC has a zero tolerance for any substances, legal or illegal, which would cause impairment to being able to perform work safely. Are you currently taking anything that could cause impairment to the performance of the job duties noted above? *YesNo

If you answered NO, please explain

All positions at PTC require the use of personal protective equipment (PPE). Is there any reason why you cannot wear PPE? *YesNo

If you answered NO, please explain

In the last three years, how much time has been missed due to illness/injury? *

Have you been injured while at work? *YesNo

If YES, please explain the type of injury sustained and the amount of time missed.

Acknowlegement

It is agreed and understood that the answers to the foregoing questions are true and correct, and that any misrepresentation of information given above shall be considered an act of dishonesty. The applicant agrees to work according to all safety regulations, policies and procedures as required by the Company or regulatory authority having jurisdiction for the worksite and agrees that failure to do so may result in disciplinary action up to termination of employment for just cause.

The applicant further agrees that in the event of a safety incident involving the applicant, and in other circumstances in accordance with the Company’s Fitness for Duty Policy, the Company may request a drug and alcohol test, all in accordance with the Company’s Fitness for Duty Policy.

It is agreed and understood that the employer, or their agents, may investigate the applicants background to ascertain any and all information of concern to applicant’s record, whether same is of record or not, and applicant releases employers and persons named herein from all liability of any damages on account to their furnishing such information.

The applicant agrees to furnish such additional information and complete such examinations asmay be required to complete
his/her employment file. It is agreed and understood that this application for employment in no way obligates the employer to employ the applicant. It is agreed and understood that if hired, the employee may be on a probationary period during which time he/she may be discharged without notice or recourse.

Consent to Disclose

Employment History
I, the undersigned, declare that the information presented above, on my resume, and application form, and information provided verbally by me to PTC is complete and accurate. I understand that a false statement provides grounds to disqualify me from employment and/or give the Company just cause for my dismissal if I am employed by it. I understand that a condition of employment with PTC is the completion of a background check, which will include the following:

Verification of my employment background and history from any source and of all data provided on my resume and/or application.
A check of criminal records for which a pardon has not been granted, and conditional and absolute discharges, which have not been removed from the Canadian Police Information Center system in accordance with the Criminal Records Act.
Driver record check for applicants applying for a position requiring a valid driver’s license.

A criminal conviction will not necessarily disqualify a candidate and only convictions relevant to the position applied for will be considered. I consent to the above information arising from the background check being collected for the purpose of conducting pre-employment due-diligence screening or where I am or have been employed, for the purpose of determining my suitability to perform security sensitive services. I understand that the Company will use the results of the background check for the purpose of conducting pre-employment due-diligence screening or where I am or have been employed, of screening my suitability to perform security sensitive services. Where this information is being collected for the purpose of conducting pre-employment due-diligence screening, and if I am hired, I consent to the information being transferred to my employee file for the purpose of the employment relationship. If I am already employed by the Company, I consent to the information being transferred to my employee file for the purpose of the employment relationship.

I agree that the Company may periodically update the background check and I agree that I shall immediately inform the Company of any conviction for a criminal offense arising subsequently to completion of the initial background check. I hereby authorize the holder(s) of the information relating to the background check, including any updates thereof as provided in the previous statements, to disclose this information to the Company and its authorized employees and/or authorized agents, subcontractors or suppliers, and to any of the Company’s clients.

I hereby release and forever discharge the holder(s) of information relating the background check, including any updates thereof to the Company, their clients and respective affiliated entities and all of their former, current or future partners, directors, officers, employees, agents, successors, and assignsfromany actions, claims and demands of any kind whatsoever in any way relating to the collection, disclosure and use of this information by the holder(s) of information relating to the background check, including any updates to the Company or clients.

I understand that personal information shall not be used or disclosed for purposes other than those for which it was collected, except with my prior consent or as required by law. Personal information shall be retained only as long as necessary for the fulfilment of those purposes.

Signature *Please type your full name - this is your signature confirming the above information

Date *