Office Staffing Candidate - Fillable Forms

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Print First/Middle/Last: Emergency Contact Name & Phone:

Date of Birth: Month/Day/Year

Home Address:

Pinnacle Office Staffing Division


Founded in Winnipeg in 2002, Pinnacle, through our commitment to excellence, has become Manitoba’s largest full-
service provider of workforce solutions. We understand that “Great People Make Great Organizations”. We are an
elite team of industry experts who bring extensive experience and commitment to exceed your expectations. Our
success is built on developing long term productive partnerships. We connect top Manitoba companies with top talent.

Pinnacle Employees Terms and Conditions


I acknowledge that the information contained within my application is true and complete. I agree, if offered
employment through Pinnacle Staffing Solutions (hereafter referred to as Pinnacle), any information contained in my
application found to be false or inaccurate, will result in immediate dismissal. It is understood that it is my responsibility
to notify Pinnacle regarding my availability for assignments. I understand that if I accept an assignment, I will be
working at different sites or companies throughout the city for Pinnacle. My signature on this document
acknowledges that I understand the length of assignment or placement is not guaranteed and can be cancelled or
terminated by Pinnacle with or without cause, at any time by a Pinnacle representative. I give my permission to
Pinnacle to send my resume and personal information on my behalf, either by fax or email, to any client of Pinnacle. I
hereby authorize a Pinnacle representative or a client of Pinnacle Staffing Solutions to check my references.

Confidentiality Agreement
I understand that while on assignment for Pinnacle, either at Pinnacle or a Pinnacle client, I may have access to private
information. I acknowledge that proprietary right of Pinnacle and/or your clients, and I agree to maintain the
confidentiality of all such information from the general population and any competitors. I further acknowledge that it
would be highly detrimental to Pinnacle, or your clients, to disclose proprietary information, both directly, or indirectly
and at no time will I copy any materials belonging to Pinnacle or your clients, including manuals, mailing list and all
other confidential material, without the express written consent of Pinnacle, or your clients.

I understand and agree to the above statements and promise to Pinnacle that I shall not, at any time, disclose any such
information to any such person. I also agree to indemnify Pinnacle and reimburse any damages or costs incurred as a
result of any breach of these terms and conditions.

Harassment Policy
We are committed, as your employer, to provide a work environment free of discrimination. Pinnacle will not tolerate
harassment of Pinnacle employees by anyone, including any supervisor, coworker, client or client employees or
supervisors.

Harassment consists of unwelcome conduct, whether verbal, physical or visual, that may be based upon sex, colour,
race, ancestry, religion, national origin, age, physical disability, medical condition, marital, veteran, citizenship or other
protected group status. Pinnacle will not tolerate harassing conduct that interferes with an individual’s work
performance and creates an intimidating, hostile and/ or offensive work environment.

Employment Equity
Pinnacle is committed to Employment Equity in order to create a diverse workforce representative of the citizens of
Manitoba. There are four designated groups: persons with disabilities, Aboriginal persons, members of visible
minorities and women. We encourage current employees or potential applicants to declare when applying for job
opportunities. Employment Equity declarations are kept in the strictest of confidence.

2nd floor, 394 Graham Ave. | Winnipeg, Manitoba | R3C 0L4 | 204.943.8649 | www.pinnacle.jobs
Designated Groups
The Employment Equity Policy designates four groups:
1. Indigenous - people of North American Indigenous ancestry, Including Métis, Inuit and First Nations (Status
and non-Status Indians)
2. Persons with disabilities - persons who have a long term or recurring impairment and who:
 Consider themselves to be disadvantaged in employment by reason of that impairment, or
 Believe that an employer or potential employer is likely to consider them to be disadvantaged in
employment by reason of that impairment, and
 Persons whose functional limitations owing to their impairment have been accommodated in their
current job or workplace.
3. Members of visible minorities- persons, other than Indigenous peoples, who because of their race or colour,
are a visible minority.
4. Women - with a focus on women in management, professional and non-traditional occupations.

Self-declaration
Self-declaration refers to the process where individuals identify themselves as belonging to one or more of the
designated groups for Employment Equity (please check all that apply):

Indigenous persons
Persons with disabilities
Members of visible minorities
Women (applying for Industrial, management or professional at Pinnacle)

PLEASE CHECK YOUR RESPONSE ☑


Our clients have different mandates, requirements, and policies regarding employment. So that we are able to make
the best possible match, please answer the following questions. Offer of employment will also be conditional upon a
review of a criminal records check.

1. Have you ever convicted a criminal offence for which you have not been pardoned? Yes No

2. Do you have a criminal record or charges pending? Yes No


If yes, please explain:

3. Have you lived in Canada for the past 5 years? Yes No

Please list two Business References (Previous supervisor or manager you reported directly to):

1) Reference Name & Title: Phone:


Company Name: Email:

2) Reference Name & Title: Phone:


Company Name: Email:

I hereby acknowledge and agree to the Terms and Conditions outlined above and give permission to contact my
references. I further acknowledge that should I not understand any of the above information, I will immediately
request clarification from a Pinnacle representative.

I would like to receive email and/or text messages from Pinnacle/Pinnacle’s Office Staffing team regarding new job
opportunities. Yes, to email Yes to text

Employee Signature Pinnacle Representative Date


2nd floor, 394 Graham Ave. | Winnipeg, Manitoba | R3C 0L4 | 204.943.8649 | www.pinnacle.jobs
Are you working with another agency similar to Pinnacle? Yes No

If yes, please take a moment to complete the information below so that we will have a better understanding of the other temporary assignments that you have completed.

This information will assist us in placing you in appropriate temporary or evaluation to hire roles.

Staffing organization
Company Name Supervisor Rate of Pay Job Title who placed you

2nd floor, 394 Graham Ave. | Winnipeg, Manitoba | R3C 0L4 | 204.943.8649 | www.pinnacle.jobs

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