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Date:

Registration Package Source:

TPS Rep:

Personal Information
First name Middle Last name

Social insurance # If 900-series, please provide expiry date Work permit/visa provided? Date of birth (MM/DD/YYYY)

/ / o Yes o No
Street address Unit City Province Postal code

Primary Phone Secondary Phone E-mail address

In the case of a workplace emergency, who would you like us to contact? Relationship to you Phone number

Please answer the following questions:


Are you legally entitled to work in Canada? o Yes o No
Do you have any criminal convictions for which you have not yet been pardoned? o Yes o No
Would you be willing to provide a background check if requested by a client? o Yes o No
Is there any type of work that, due to a past or present medical condition, you cannot perform? o Yes o No
If yes, please explain:
Position Applying For Expected Hourly Wage Date Available to Start

Availability Limitations Protective Equipment & Training


Days available Shift Availability Transportation Check the boxes beside equipment or training that you have:
o MON o Day o Vehicle/Drive self Equipment/Tools Training/Experience
o TUES o Afternoon o Rely on Carpool/Public Transportation o Safety Shoes/Boots o Lock out/tag out
o WED o Night o Prefer to only bike/walk o Safety Glasses o Working at Heights
o THURS o Weekend Lifting Capabilities o Safety Vest o Confined Space
o FRI Length of term o 10-20 lbs o Work Gloves o Respirator (full mask)
o SAT o Short term o 20-50 lbs o Hard Hat o Asbestos Removal
o SUN o Long term o 50-100 lbs o Welding Helmet o First Aid/CPR
o Varies o Any o No lifting / medical limitations o Tools

Prior Work Experience


Have you ever been employed by TPS? o Yes o No
Have you ever been employed by a temporary staffing agency before? o Yes o No
If yes, please list: Agency Name Company sent to Position/Duties Pay rate

Please check the skills that you have experience in and provide details where available:
INDUSTRIAL/GENERAL SKILLED LABOUR CONSTRUCTION DRIVER OFFICE
 Assembly  CNC Operator  Carpentry  G Class  Accounting
 Flagging  CNC Programmer  Concrete Pouring  A/Z  Accounts Receivable
 Inspection/grinding (parts)  Forklift (certified)  Concrete Finishing  D/Z  Accounts Payable
 Janitorial/Cleaning  Heavy Equipment (cert)  Demolition  Coach  Bookkeeping
 Forklift (experienced) Type: _________________  Door Installation  Bus  Data Entry
 Greenhouse  Injection Molding  Drywall Installation  Tank  Filing
 Inventory Type: _________________  Drywall mud & tape  Dump  Human Resources
 Landscaping  Metal Work  Framing  Pump  Management
 Machine Operator  Sandblasting  Masonry  A/B Train  Medical Office
Type: _________________  Scissor/Boom Lift (certified)  Renovation  Oversize Type: _________________
 Material Handling  Welding (certified)  Restoration  Roll-off  Payroll
 Moving (residential) Type: _________________  Roofing (labour)  Flatbed  Reception
 Moving (commercial)  Other  Roofing (shingler)  Cross Border  Supervisor
 Order Picking/Packing  Window Installation  Long Haul
 Quality Control/Sorting DETAILS:  Local Only  Computer
 Recycling ____________________________  Own Tools  LTL  Windows
 Retail/Cash ____________________________  Fast Card  Mac
 Sanding/Finishing ____________________________ DETAILS:
 Shipping/Receiving ____________________________ ____________________________ When applying for a driving position, SOFTWARE:
 Warehouse ____________________________ ____________________________ TPS requires a copy of valid driver’s ____________________________
 Welding (experienced) ____________________________ ____________________________ license, recent driver’s abstract & ____________________________
Type: _________________ ____________________________ ____________________________ CVOR. ____________________________
Education
Name/Location Last year completed Diploma/Degree Major/Emphasis

High School 9 10 11 12

College/University 1 2 3 4

Technical/Trade School

Other
Employment History (Most Recent First)
o See Resume
Company Name Job Title Pay rate

Duties

Dates of Employment Reason for Leaving

Supervisor's Name Phone # or Location Reference?

o Yes o No

Company Name Job Title Pay rate

Duties

Dates of Employment Reason for Leaving

Supervisor's Name Phone # or Location Reference?


o Yes o No

Company Name Job Title Pay rate

Duties

Dates of Employment Reason for Leaving

Supervisor's Name Phone # or Location Reference?

o Yes o No

References
Contact Name Type of Reference/Company & Position Phone #

Reference/Registration Release: I confirm that all information provided in this registration package is true and complete, and I understand that any
falsifications, omissions, or misrepresentations will result in my disqualification from consideration for employment or if employed, my dismissal for
just cause. In consideration of my employment, I agree to conform to the company’s rules and regulations (terms & conditions), and I understand and
agree that these rules/terms may be changed at any time by TPS without direct notice to me (changes will be posted in office). TPS may verify the
information set forth in this registration package and obtain additional background information relating to my employment/consideration for
employment. I authorize all persons, schools, companies, corporations, and law enforcement agencies to supply all information concerning my
background. I understand that completing and signing this registration form, and/or any forms contained within it, does not constitute nor guarantee
employment or placement with TPS. Within 3 days of my first day of employment with TPS, I agree to provide any outstanding proof of identity/age,
Social Insurance Number, other appropriate credentials as required and direct deposit information (if requesting direct deposit for pay).

Date Registrant Signature Witness / TPS Representative


Terms & Conditions

I, _______________________________________________________________________ (print name), acknowledge that in order to be considered for


employment with TPS, it is my duty to read and understand the following terms.
By initialing beside each statement below, I understand and agree to the following:
To contact TPS on a regular basis when not on a current assignment, to
maintain my active status with the company and be considered for future To report all workplace injuries (including repetitive strain or sprain
assignments. injuries), illnesses or near miss incidents to a client supervisor and TPS as
soon as possible after the incident occurs.
To promptly notify TPS of any changes in personnel data, such as (but not
limited to) mailing address, telephone numbers, and individuals to be
contacted in the event of an emergency. To complete all incident related paperwork in a timely manner (within 48
hours) and maintain contact with TPS during the investigation process.
To participate in the required training & orientation programs as scheduled
and on an annual basis from that point thereafter.

To attend all shifts as scheduled, on time (10-15 minutes prior to shift start To participate in TPS’s Early & Safe Return to Work Program, including
time), and report any absence or lateness to TPS as soon as possible prior accepting modified duties as assigned by TPS (TPS will always limit modified
to the scheduled shift. duties to those things that can physically be done within any medical
restrictions the attending physician has set)
To follow through with accepted assignments, attending all shifts as
scheduled for the duration of the assignment, unless extenuating
circumstances, which shall be discussed with TPS management, prevent me To periodically review all TPS Health & Safety policies and procedures to
from doing so. ensure that I have the most up to date information available, and adhere
to these policies and procedures at all times.
To dress appropriately for each job as required, and maintain a
professional appearance and demeanor during my assignments. This
includes wearing all required Personal Protective Equipment for the That once I have been to an assigned client, I will have become an
duration of my shift. employee of TPS, and as such, am required to relay all employment related
questions or concerns to the TPS office, NOT the client site I am assigned
To sign in and out properly for each shift, and submit my timecards, to. This includes (but is not limited to) questions about scheduling, pay
properly filled out and signed by my supervisor, to TPS by no later than increases and/or bonuses.
noon on the Monday following my work week. I understand that failure to
do so will result in a delay in my pay. (TPS processes one payroll run per
That TPS does not prohibit any of its employees from seeking full-time
week. Delayed pays will be issued on the next regular pay day.)
work, or part-time work, at any other agency or employer. Employees are
not reprimanded for working elsewhere, or securing full-time employment,
To never remove any equipment or property which belongs to TPS, or it even through our clients. TPS's clients are under contract with TPS, not our
clients, from any worksite. employees. A client may hire any of our workers, however, they will have
contracted stipulations in doing so.
To not incur any expense on behalf of, nor bind, TPS by any promise or
representation without prior expressed, written approval.
That TPS's clients reserve the right to request and/or cancel assignment
workers at their leisure. I understand that I am not to attend a client site
To never possess, consume, solicit or be under the influence of drugs or
after TPS has informed me not to attend. This includes (but is not limited
alcohol at a client site, before shift commencement, during shift hours
to) attending to remove personal property, or to inquire about work or the
and/or on breaks.
lack of. Please request TPS office staff to retrieve any personal belongings
you may have left behind.
To refrain from behaviour or actions that may be deemed as violence,
harassment or discrimination in the workplace, and to report any
That TPS does not encourage employees' leaving personal property at
behaviour or actions that I may witness or experience that may be deemed
client sites. TPS, and/or its clients, will not be held responsible for any
as violence, harassment or discrimination to TPS immediately.
property that cannot be found during or after an assignment ends.

To behave in a mature, responsible manner, and refrain from behavior that


That TPS uses a progressive disciplinary system. However, it is at the
could result in disciplinary action, up to and including termination of my
discretion of TPS management to determine if a specific violation may be
employment with TPS.
grounds for immediate termination, regardless of my previous disciplinary
To follow all safety rules, policies and procedures of TPS and its individual record.
clients, and attend all training as necessary to ensure my safety at the jobs I
am assigned to. That TPS will try to have comparable placements available when my
assignment ends, however, this in no way guarantees any future placement
To always have and wear all required PPE for the client site that I am
or assignment.
assigned to, and to maintain said PPE in good repair, or replace when
necessary.
To not disclose, directly or indirectly, or use in any way, either during the
term of employment or at any time thereafter, except as required in the
To report any and all hazards I may find on client job sites, including
course of employment with TPS, any information of a confidential nature.
malfunctioning equipment and/or safety guards and/or barriers, and/or
This includes, but it not limited to, information you are exposed to at client
any and all unsafe work that is requested of me by the individual clients.
sites.

By signing below, I agree that I have had the opportunity to ask any questions which I may have regarding these terms. I understand that, at any time,
any further questions or concerns I may have regarding TPS’s policies and/or procedures can be directed to the management, supervisors and/or
owners of TPS I agree to abide by all rules and regulations as stated, and understand that the rules and policies agreed upon are those of TPS, and as
such, if I am found to not be respecting them, TPS retains the right to disqualify my application for consideration for employment, or, if employed,
discipline or terminate my employment accordingly, at their discretion.

Date Registrant Signature Witness / TPS Representative


EMPLOYMENT STANDARDS - Industries with Special Rules & Exemptions
The Employment Standards Act, 2000 (ESA) applies to most employers and employees in Ontario. However, certain industries and/or jobs covered by the ESA are exempt from
(that is, not covered for) some provisions, or are subject to special rules. For complete information, please refer to the ESA and its regulations. A copy is available for review in
our office at all times.

When working in these industries, you will not be eligible for various provisions, like overtime premium pay, statutory holiday pay, hours of work, daily rest periods, etc. Some of
the industries not covered for these provisions, or which include special rules about them, include greenhouse, farm labour/harvesting, construction, highway transport truck
drivers, etc.

TPS will always try to inform you if an assignment you are accepting falls into one of these categories, however it is your responsibility to know your rights and responsibilities
under the ESA.

Please also understand that, while it is entirely your choice to not work in an industry where special rules or exemptions apply, many of TPS’s seasonal clients DO fall into these
categories. This means that the availability of work which we may assign you to may be limited and you may have a lengthy wait prior to an adequate placement becoming
available.

PLEASE CHOOSE AND SIGN ONLY ONE OPTION BELOW:


I am willing to accept job placements with provisions not covered by the ESA, or
with special rules, and understand that I may be working all hours available at a
regular rate of pay, may be eligible for overtime pay at a number of weekly hours I do not wish to work at any assignment where all
higher than 44, may not be eligible for statutory holiday pay, may be required to provisions are not covered by the ESA.
work more than the standard number of daily/weekly hours, or some other
special rule or exemption.

Date Registrant Signature Witness / TPS Representative

Space below is for OFFICE USE ONLY


Test Scores & Recruiter Notes
Recruiter comments:

WHMIS / 16 Measure /3
Match/
Logic / 10 Spelling /6

Math / 12 Visual /6
Copies/Forms
Please check off all items that are included in the applicant's file:
o SIN (or visual verif) o Direct Deposit form or cheque o Certificates for skilled work o Other:
o Copy of photo ID o Provincial tax form (TD1-ON) o 900 series SIN (with expiry)
o Resume o Federal tax form (TD1) o Copy of Work Permit/Visa
Reference
Reference completed by (TPS Rep): Date:

Reference Name: Company:


Rate each area from 1-5, 5 being the Description of duties / comments:
highest:

Quality of work

Punctuality & Attendance

Attitude

REHIRE? ____ Y ____ N TPS REPRESENTATIVE SIGNATURE:

TPS Employment
First Assignment Hire Date Pay Rate

Notes

Termination Date Reason ROE Issue Date

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