Employee Submission Form

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Experience

Present or Last Employer

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TO HELP US FIND SUITABLE EMPLOYMENT FOR YOU PLEASE COMPLETE THE FOLLOWING

Location

If I am employed with Jill Peapell Personnel Consultants Limited to work on temporary assignments, I agree not to accept a position of any kind with clients to whom I have been assigned for a period of 120
days without prior authorization by Jill Peapell Personnel Consultants Limited.

TO: SUPERTEMP, A DIVISION OF JILL PEAPELL PERSONNEL CONSULTANTS LIMITED and to each firm,
corporation, or business I may be assigned to by you to work and to perform services for (the latter
parties being hereinafter referred to as “clients”),
I,

in consideration of my employment with SUPERTEMP,
and in my recognition of the fact that without this agreement I would not be assigned by SUPERTEMP
to work for and perform services for its clients, hereby covenant, agree, and declare as follows:

1. I recognize that by virtue of my employment I may acquire Confidential Information or have
access to Restricted Data (hereinafter referred to as “information”) all of which is the
property of the party to whom I have been assigned to work or provide services for (clients).

2. I will diligently keep secret all such information in whatever form and regardless of how it
comes to my attention.

3. I will not at any time, directly or indirectly, disclose such information to anyone nor will I at
any time use such information for myself.

4. I recognize that such information, be it contained in related memoranda, data, sketches,
computations, prints, documents, drawings, specifications, records and the like, are
valuable property rights belonging to the party to whom I have been assigned to work for
(clients), and are and will be received by me in confidence and in trust without further
disclosure, production, and transmittal.

5. I further covenant and agree that upon leaving any assignment I will not take with me any
such memoranda, data, sketches, computations, prints, documents, drawings,
specifications, records, and the like, nor any reproductions thereof.

6. Clients are entitled to rely upon this agreement as if the named party of signatory thereto.

7. Should a client, associate, or subsidiary company choose to offer you employment, you first
may be required to fulfill your obligation with SUPERTEMP. We request that you notify
SUPERTEMP immediately should you be offered employment.

Signature

Employment Equity Information

Under the Federal Contractors Program for Employment Equity, Supertemp is required to maintain data on the representation of
Aboriginal or First Nations peoples, persons with a disability, racially visible people, and women, both in our workforce and applicant
pool.
The Charter of Rights and the Nova Scotia Human Rights Commission permit employers to collect the data they require to plan and
support special programs. Your voluntary response to the questions below will assist us in the administration of our Employment
Equity program and enable us to conduct research and analysis on the effectiveness of these measures.
The information you provide will be held in strictest confidence by Supertemp. It will not be released to anyone without your
consent.

Choose gender

Aboriginal or First Nations peoples include persons in Canada who identify themselves as status or
non-status Indian, Inuit, or Métis.

Members of racially visible groups are persons in Canada who identify themselves to be non-white in
colour or of non-Caucasian racial origin.

Persons with a disability are persons who have a long-term or recurring physical, mental, sensory,
psychiatric, or learning impairment and who

a) consider themselves to be disadvantaged in employment by reason of that impairment, or

b) believe that an employer is likely to consider them to be disadvantaged in employment by
reason of that impairment,
and includes persons whose functional limitations owing to their impairment have been
accommodated in their current job or workplace.

Employee Equity Information Signature