Work Permit Form

Contact name and position*

Are you the employer or the employee?*

Legal name of the business

Main telephone number*

E-mail*

Business address

Worker's country of residence

Exact date business started (dd/mm/yyyy)

Short description of what the business does

Worker's nationality

Worker's country of residence:

If different from his/her home country: What is his/her legal status?

Has the worker applied for a Canadian Visa? If so what was the outcome?

If the visa was issued, did he/she overseas in Canada?

Has the worker ever been deported?

Number of foreign workers currently employed

Total number of employees currently employed (including foreign workers)

Positions and wages ($ per hour)

How many hours per week will the employee be working?

Will the company provide housing to the workers, if so at what cost?

Were any employees laid off in the last 12 months? If so, how many? And why?

Is there a labour dispute in process? If so, explain

Does the company provide disability, medical and dental insurance? Pension?

What other benefits does the company provide? i.e uniform, discounts?

Are the positions part of a union? Provide details