Application Form, Ontario – Universal Staffing

Please select the Universal Staffing branch that is located closest to you.

First Name *

Middle Name

Last Name *

City/Town *

Province *

Postal Code *

Email *

Home Number

Cell Number *

Name of School

Year Completed

Employment History

Company Name

Company Phone Number

Supervisor's Name

Employed From

Employed To

Job Title

Duties

Rate of Pay ($/hr)

Reason for Leaving

Job Title

Supervisor's Name

Employed From

Employed To

Company Phone Number

Duties

Rate of Pay ($/hr)

Reason for Leaving

If you have listed previous employment above, do you authorize Universal Staffing to contact your previous employers for the purpose of employment verification and/or conducting a reference? *

YES
NO
Not Applicable

Forklift

Cherry Picker
Clamp Truck
Counter Balance
Raymond Reach

Driving

DZ License
AZ License
G License
Other

List any certificates or other skills you may have

Acceptable Starting Rate ($)

Pre-employment Test

Please enter the correct number for the math questions and select the properly spelled word in the list.

80 + 20 - 27 = *

100 ÷ 4 = *

42 x 3 = *

10 + 29 + 22 = *

Spelling test 1 *

occurrence
occerence

Spelling test 2 *

factory
factourie

Spelling test 3 *

fourman
foreman

Spelling test 4 *

asinment
assignment

Please click the WHMIS DOCUMENT link below and read the material document provided and respond to ALL questions to the best of your ability. Click here to view the WHMIS DOCUMENT

1. What does WHMIS do? *

Establish rules for classifying hazardous products
Requires supplies to attach labels to products
Requires suppliers to provide SDS
All of the above

2. What does GHS stand for? *

Good Health Standards
General Health Signal
Globally Harmonized System
Graphic Honour System

3. Under WHMIS the acronym MSDS means Material Safety Data Sheet, Under GHS what do the letters SDS stand for? *

Safety Data Standards
Storage Department Sheets
Safety Data Sheets
Safety Division Standards

4. What are the two Hazard groups used in WHMIS? *

Physical & Mental
Mental & Health
Health & Physical
Health & Safety

5. What are the “two signal” words used in GHS? *

Danger and Warning
Warning and Harmful
Danger and Caution
Warning and Attention

6. GHS classifies chemical hazards so that the workplace hazard communication is the same worldwide. *

TRUE
FALSE

7. Important information on the hazards, protective measures & safe use of material can be found on the container label. *

TRUE
FALSE

8. The signal for “Warning” means the hazard is “Less Serious” and “Danger” means “More Serious”. *

TRUE
FALSE

Select the appropriate answer for each symbol below.

Gas Cylinder *

Flame *

Skull and Crossbones *

Exclamation Mark *

Biohazard Infectious Materials *

Exploding bomb *

Corrosion *

Health Hazard *

Flame over circle *

Policy/Procedures Test

Please indicate the correct answer for company policies and procedures

Please read the following and sign below to acknowledge acceptance and understanding of all conditions of registration.

I grant permission to Universal Staffing Inc. to use this information to their discretion and contact the reference person I provided. I understand this form is only a registration with Universal Staffing and on completion of my first day worked I will then become an employee accordingly. I understand in order to gain and maintain my employment status with Universal Staffing Inc. I am responsible for weekly contact with my Staffing Consultant. I understand I may be not be suitable for certain assignments and if employed I must agree to follow policies, procedures and follow all direction accordingly. I understand that I am responsible to providing Universal Staffing with any information if any changes occur before or after an offer of employment.

Upload related files (ie. resume, CVOR, Drivers abstract)

Drop your files here or click here to upload You can upload up to 3 files.

Please sign below *

You can use your finger on a touch device or a mouse to sign your name.

Health & Safety Awareness Quiz

Step 4

1. If you report a dangerous situation to your supervisor and your health and safety representative and they can’t find a way to fix it, you can call the Ministry of Labour’s toll-free number for help. *

2. If you have reason to believe the equipment you are using might hurt you or someone you work with, you have the legal right to refuse the work. *

3. Some workers, such as nurses, firefighters and police officers, have a limited right to refuse work. *

4. It’s against the law for your employer or your supervisor to fire or punish you for doing what the OHSA expects you to do, or for asking them to do what the OHSA expects them to do. *

Please type your name *

Please sign your name in the box below *

You can use your finger on a mobile device, or your mouse on a computer.

branch

Branch to contact *

Name *

Email *

Phone Number

Message