APPLICATION FOR EMPLOYMENT

Consent to Release Personal Information

(Confidential When Completed)

Personal Data

Last Name First Name Full Middle Name Maiden Name

Address DOB: yy/mm/dd Sex: M/F

City Province Postal Code Place of Birth

Please clearly print a personal email address and phone number that ISL can contact you.

Identification Documentation (Copy of two of the following documents required)

Drivers License Birth Certificate Passport Other

Province Province Country Province/Country

I certify that the above-named individual has identified himself/herself to me by means of at least two reliable identification documents
as indicated above.

Signed: ______________________________________ Date:__________________________

Position:_____________________________________

I, the undersigned, grant permission to my prospective employer and its representatives to collect personal information about me
(including test results of any kind) and to conduct reference and credit checks and a criminal record search for criminal convictions for
which a pardon has not been granted. This information may be used to evaluate my application for employment and, if I am hired, this
information may be shared with my prospective employer’s affiliated or related companies should I be considered for employment by
any such companies. This permission includes my consent to the collection, use, disclosure and retention of information under the
Personal Information, Protection and Electronic Document Act (Canada) or similar provincial legislation.

I specifically consent to the release, by the police and/or the Provincial Court, of any criminal record or other conviction information to
Industrial Security Limited, notwithstanding that I have not reviewed the results prior to release. This includes information related to
criminal convictions or criminal charges.

Applicant’s initials:______

I understand that refusal to give my consent for this release will not reflect negatively on my application and that I have the choice of
having the criminal records check results returned directly to myself by police or Provincial Court Officials.

Applicant’s initials:______

Signed: __________________________________________________ Date:___________________________________