2743 Emerson Street
Abbotsford, B.C. V2T 4H8
Ph: 604.852.3701
EMPLOYMENT
www.houseofjames.com
QUESTIONNAIRE
Due to the unique nature of this store's products we reserve the right to designate certain job descriptions as open to
applicants with specific knowledge about Christian books, literature, and music, etc.
PERSONAL INFORMATION Date:
Name ( )
Last First Middle Telephone
Address
Street City Prov. Postal Code
Email
Position(s) applied for Salary desired
When available
How many hours per week are you looking for? Evenings? Saturdays
Are there days/times that you are NOT available?
PROFESSIONAL SKILLS & LITERATURE INTERESTS
Keyboarding Speed WPM. Software applications you are familiar with, including online services such as web
design, publishing or image design suites:
Computer proficiency 1 - 3 - 5 - 7 - 8 - 10 Have you worked a Till in the past? Y / N
Previous work with the public, including group presentation or leadership experience:
Are there any experiences, skills, or qualifications, which you feel would be helpful to us in considering your application
(e.g. Familiarity with Bible translations or managing Social Media platforms ).
With which Christian Bookstores and Publishers are you familiar?
List 5 - 10 books you've read in the past 2 years:
List 5 - 10 Christian music artists you are familiar with:
PHYSICAL INFORMATION
Do you have any physical conditions for which we would need to make special arrangements or accommodations (e.g.
hearing, speech, vision, etc.)? Y / N
If yes, please describe
Do you have any physical conditions (e.g. back, legs, or feet trouble) which prevent you from being on your feet,
standing or lifting for prolonged periods of time, or limitations which could affect your performance of the position for
which you are applying? Y / N If yes, please describe
FORMAL EDUCATION
High School College/University
School Name/Location
Last Year Completed 9 10 11 12 1 2 3 4
(circle)
Diploma/Degree
Course of study
Specialized training, Skills,
Apprenticeships, Extra-
curricular activities.
EMPLOYMENT HISTORY
List each job held - start with your present or last job, include volunteer activities if applicable.
My present employer may may not be contacted.
A. COMPANY Phone ( )
Address
Street City Prov. Postal Code
Position Supervisor
Salary Range Dates
Description of duties
Identify areas of personal growth from this position
Reason(s) for leaving
B. COMPANY Phone ( )
Address
Street City Prov. Postal Code
Position Supervisor
Salary Range Dates
Description of duties
Identify areas of personal growth from this position
Reason(s) for leaving
C. COMPANY Phone ( )
Address
Street City Prov. Postal Code
Position Supervisor
Salary Range Dates
Description of duties
Identify areas of personal growth from this position
Reason(s) for leaving
GENERAL INFORMATION
Explain why you want to work here:
Explain what you could offer a store such as ours:
What area of the store is of special interest to you?
Are your plans to work here short term (less than 2 years) or long term (more than 2 years)?
Explain
REFERENCES
Give name, address, and phone number of three references not related to you, whom you have known for at least one
year (indicate type of acquaintance, e.g. business associate, friend, etc.).
( )
Name Telephone Relationship
( )
Name Telephone Relationship
( )
Name Telephone Relationship
AGREEMENT
I authorize verification of all statements contained in this questionnaire, including contacting my past employers.
I understand that this application is not intended to be a contract of employment. I understand that misrepresentation or
omission of facts called for constitutes cause for dismissal.
Signature of Applicant Date
PLEASE NOTE THAT ONLY APPLICANTS SELECTED FOR INTERVIEW WILL BE CONTACTED.
