Transportation

Highschool

University or College

Other University or College

Other University or College

If employed by Jill Peapell Personnel Consultants Limited to work on temporary assignments, are you normally
available the same or next day?

Applications Software
Please note your experience level for these programs
Level: 1 = trained 5 = expert

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

How did you hear of us?

Are you a permanent resident or Canadian citizen?

YesNo

Are you on a work permit?

YesNo

If yes, which one?

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.

I certify that the information contained in this application is true.

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.

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.

Name:

Write full name

If you authorize the release of this information to an employing Department, please check here:
Do not share

Gender:
FemaleMaleNon-Binary

Aboriginal or First Nations peoples include persons in Canada who identify themselves as status or non-status Indian, Inuit, or Métis. If you consider yourself to be a member of this group, please specify:
Mi'kmaqOther Aboriginal

Members of racially visible groups are persons in Canada who identify themselves to be non-white in colour or of non-Caucasian racial origin. If you consider yourself to be a member of this group, please specify:
Nova Scotia Indigenous BlackOther Racially VisibleOther Black

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. If you consider yourself to be a member of this group, please indicate:

Yes

Thank you for taking part in this survey.

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