201-3075 Boulevard Thimens,

Montreal, Saint-Laurent,
Quebec H4R 1Y3, Canada.
Tel: +1 (782) 201-9925
WhatsApp:(782) 201-9925

We are an Equal Please print, fill up. The

Opportunity Employer and application must be fully
Application For Employment is committed to excellence completed to be
through diversity. considered. Please
Form must be filled up in a complete each section
hand written manner only. very important.

Personal Information
Name

Address City State Zip

Phone Number Mobile Number Email Address

Are You A Canadian Citizen? Have You Ever Been Convicted Of A Felony?
Yes No Yes No

If Selected For Employment Are You Willing To Submit to a Pre-Employment Drug Screening Test?
Yes No

Position
Position You Are Applying For Available Start Date Desired Pay

Employment Desired
Seasonal/
Full Time Part Time
Temporary

Shift Availability
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
From

To

Overnight

Education
School Name Location Years Attended Degree Received Major
 201-3075 Boulevard Thimens,
Montreal, Saint-Laurent,
Quebec H4R 1Y3, Canada.
Tel: +1 (782) 201-9925
WhatsApp:(782) 201-9925

References
Name Title Company Phone

Employment History
Employer (1) Job Title Dates Employed

Work Phone Starting Pay Rate Ending Pay Rate

Address City State Zip

Employer (2) Job Title Dates Employed

Work Phone Starting Pay Rate Ending Pay Rate

Address City State Zip

Employer (3) Job Title Dates Employed

Work Phone Starting Pay Rate Ending Pay Rate

Address City State Zip

Employer (4) Job Title Dates Employed

 201-3075 Boulevard Thimens,
Montreal, Saint-Laurent,
Quebec H4R 1Y3, Canada.
Tel: +1 (782) 201-9925
WhatsApp:(782) 201-9925

Work Phone Starting Pay Rate Ending Pay Rate

Address City State Zip

Employer (5) Job Title Dates Employed

Work Phone Starting Pay Rate Ending Pay Rate

Address City State Zip

Signature Disclaimer
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview
may result in my release.

Name (Please Print) Signature

Date
 201-3075 Boulevard Thimens,
Montreal, Saint-Laurent,
Quebec H4R 1Y3, Canada.
Tel: +1 (782) 201-9925
WhatsApp:(782) 201-9925

LUFA FARMS ONLINE INTERVIEW

Have you ever been convicted of a felony?  Yes  No

If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s)
was/were committed, sentence(s) imposed, and type(s) of rehabilitation.
 201-3075 Boulevard Thimens,
Montreal, Saint-Laurent,
Quebec H4R 1Y3, Canada.
Tel: +1 (782) 201-9925
WhatsApp:(782) 201-9925

Have you ever been in the armed forces?  Yes  No

Specialty _______________________ Date Entered __________ Discharge Date ___________

Are you now a member of the National Guard?  Yes  No

If hired, can you provide proof of Canada citizenship  Yes  No

or proof of your legal right to live and work in this country?

Have you ever been employed with this Company?  Yes  No

If yes, when? ______________

Do you have any friends or relatives employed by this Company?  Yes  No

If yes, please provide their names and relationship to you. ________________________________________

If hired, would you have a reliable means of transportation to and from work?  Yes  No

Are you able to perform the essential functions and duties of the job for which you are applying?  Yes  No

If not, please describe the functions or duties you are unable to perform. ___________________________

YOU ARE TO ANSWER THE ABOVE INTERVIEW QUESTION CORRECTLY BECAUSE IT WILL BE USED
TO JUDGE YOUR ABILITIES AND ALSO HELP YOU IN ORDER TO BE CONSIDERED FOR AN
APPOINTMENT WITH OUR COMPANY. YOUR ANSWERS WOULD ENHANCE THE CHANCES OF YOU
BEING SELECTED TO BE OFFERED AN APPOINTMENT LETTER.