151 Davis Road,   Kenora ,  ON,  P9N 0E7

Phone: (807) 548-8785    Fax: (807) 548-8789

       Email: info[at]dorseycontractinginc[d0t]com

Planting Application

Contact Information:

                                         First Name *    Last Name *

                                      Home Phone - -                Cell/Other Phone - -   

                                              Address

                                                      City    Province/State    Postal/Zip Code

                                                   Email *       * required fields

Personal Information:

                                                     Age                    Birth Date DD/MM/YYYY                    Sex Male Female

                                                 Valid Driver's License Yes No       Class    Province  

                                                 Height ft. in.     Weight lb.

Emergency Contact Information:

                                   Contact Name    Relation    Phone - -

Work Availability:

                                    check option(s) of interest            (NOTE: there is NO option to work the Alberta/British Columbia segment ONLY)          

                                                            May 1 through to June 30 in Manitoba & NW Ontario

                                                            AND July 10 through to August 10 in Alberta & British Columbia

Education:

                                    check relevent option(s)

                                                            Completed High School

                                                            Attending a Post Secondary School Institution

                                    Name of Post Secondary School Institution

                                    How many years are you planning to attend?

                                    What is your Major?

Medical Information:

                                    Any Injury to:     Knees              Back              Wrists             

                                                              Other,   Please Specify

                                    Any other past or present injuries, handicaps or allergies we should be aware of?

                                   Are you currently in good health?  Yes No

                                    Describe your physical condition.

                                   Dietary Information (ie. vegetarian):

Work/Training Experience:

                                   List any certificates, special skills, or training you may have

Work References:    

                                  (we may contact)

            Name                                  Phone                            Position                               Location                    Dates Worked (DD/MM/YYYY)

    - -             -

    - -             -

    - -             -

Personal references:

                            Name                                       Relation                         Years known                   Phone

                                                        - -

                                                        - -

Miscellaneous Questions:

                                                  1. Have you planted trees before?   Yes   No

                                                  2. Do you know anyone who has planted trees? 

                                                  3. How did you find out about Dorsey Contracting?

                                                  4. What do you think planting trees would be like?

                                                  5. Why do you want to go tree planting?