Dominion Caribbean Limited

APPLICATION FOR EMPLOYMENT

Date of Application (D/M/Y) *
Full Name: *
Place of Birth (City, Country) *
Citizenship: *
Passport Issued By: *
Passport Issue Date (D/M/Y) *
Passport Number: *
Bahamian NIB Number (Enter N/A if you do not have one): *
Do you have a work visa for the Bahamas? *	Yes No
If Yes, list number:
How did you hear about Dominion Caribbean Limited? *
Position Applying For: *
TELL US ABOUT YOURSELF
Trade School/College: *	Yes No
If yes, list Degree/Trade Level:
Further Schooling? *	Yes No
If yes, list Degree/Trade Level:
Further Schooling?	Yes No
If yes, list Degree/Trade Level:
WORK HISTORY
Previous/Past Employer
Company: *
Location: *
Position: *
Supervisor: *
Prior Employer
Company:
Location:
Position:
Supervisor:
Prior Employer
Company:
Location:
Position:
Supervisor:
FURTHER INFORMATION
When are you able to start work? *
Are you willing to travel/relocate? *	Yes No
Heath: *
At Will Employment * I acknowledge that if hired, I will be an at will employee. I will be subject to dismissal or discipline without notice, warning or cause at the discretion of the Company. I understand that no representative of the Company, other than the President, has the authority to change the terms of an at will employment.	Agree Do Not Agree - Withdraw Application

Accuracy: * The information provided in this Application for employment is true, correct, and complete. I understand that if I am hired, any misstatement or omission off act on this application may result in my immediate dismissal.	Agree Do Not Agree - Withdraw Application
Documentation * If I am offered a positon I am willing to have a health examination prior to the start of work. I understand if I am deemed not fit for work my offer will be withdrawn.	Agree Do Not Agree - Withdraw Application
Travel/Relocation * I understand if I am responsible for all costs of travel/relocation as may be necessary to work at specified sites - the costs will be calculated in my salary. I do not expect other compensation.	Agree Do Not Agree - Withdraw Application
CONTACT INFORMATION
Telephone: *
Email: *