APPLICATION FORM

Fill application form below to apply for a position. The information I am presenting in this application is true and correct to the best of my knowledge, and I understand that any false statement, misrepresentation, or omission, shall be sufficient cause for rejection or dismissal in the event I am employed by Lico Machinery Inc. By sending this form, I autorise Lico Machinery Inc. and Firme Cogites to verify the information set forth on this application and obtain additional information relating to my background.

PERSONNAL INFORMATION
Last Name*		First Name*
Phone*		Phone (other)
Email*
Address*		City*
		Postal Code*
POSITION SOUGHT
Position*	Administration Dessinateur Journalier Mécanicien industriel Soudeur-monteur Autre	Available*
Other		Desired Pay Range
EDUCATION
Secondary School*	1 2 3 4 5	Degree obtained*	Yes No
Subject of study
CEGEP	1 2 3	Degree obtained	Yes No
Subject of study
Other (specify)		Degree obtained	Yes No
Subject of study
EMPLOYMENT HISTORY
Employer		Employment dates
Position		Reason for leaving
Employer		Employment dates
Position		Reason for leaving
Employer		Employment dates
Position		Reason for leaving
REFERENCES
Name		Phone
Address
Name		Phone
Address
Curriculum vitae (Word or PDF)		*Areas marked with an asterisk (*) are required.