Membership Application

Membership Application

Once we have reviewed your application, if we think you're a good fit with LIUNA, we will contact you.

Multipage

Step 1 of 8 Personal Information

First Name *

Last Name *

Sex *

Male

Female

Age *

Address *

City/Town *

Province *

Postal Code *

Home Phone *

Cell Phone

Email *

Social Insurance Number

Do you have a driver's license? *

Yes

No

License #

Classification

If no, explain why

Do you have an automobile? *

Yes

No

Are you currently a member of any union? *

Yes

No

If yes, which union?

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Step 2 of 8 Personal History

Any injuries or disabilities? *

Yes

No

WSIB *

Yes

No

Have you made a previous claim? *

Yes

No

Do you have any physical restrictions? *

Yes

No

If yes to any of the above, please explain

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Step 3 of 8 Education

Are you currently in school? *

Yes

No

If yes, what is the name of the school?

Name of the program?

Elementary School History

Elementary School Level Reached

(Degree, Diploma, Certificate, License)

Elementary Institution

Year Obtained

Secondary School History

Secondary School Level Reached

(Degree, Diploma, Certificate, License)

Secondary Institution

Year Obtained

College History

College Level Reached

(Degree, Diploma, Certificate, License)

College Institution

Year Obtained

University History

University Level Reached

(Degree, Diploma, Certificate, License)

University Institution

Year Obtained

Other Training

(On-the-job, volunteer, apprenticeship)

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Step 4 of 8 Language and Mathematics

What is your first language? *

What other languages do you speak?

Ability to read English *

Poor

Fair

Good

Excellent

Ability to write English *

Poor

Fair

Good

Excellent

Ability to speak English *

Poor

Fair

Good

Excellent

Can you add, subtract and multiply whole numbers? *

Yes

No

Can you add, subtract and multiply fractions and decimals? *

Yes

No

Can you find the area of a circle, triangle, square, etc? *

Yes

No

Rate your ability working with imperial measurements *

Poor

Fair

Good

Excellent

Rate your ability working with metric measurements *

Poor

Fair

Good

Excellent

4 / 8

Step 5 of 8 Work Experience

Most Recent Employer

Company 1

Date 1

Empty 'End date' values will use the 'Start date' values.

Date

E.g., 06/27/2020

to:

Date

E.g., 06/27/2020

Job Duties 1

Reason for Leaving 1

Contact for Reference 1

Previous Employer

Company 2

Date 2

Empty 'End date' values will use the 'Start date' values.

Date

E.g., 06/27/2020

to:

Date

E.g., 06/27/2020

Job Duties 2

Reason for Leaving 2

Contact for Reference 2

Previous Employer

Company 3

Date 3

Empty 'End date' values will use the 'Start date' values.

Date

E.g., 06/27/2020

to:

Date

E.g., 06/27/2020

Job Duties 3

Reason for Leaving 3

Contact for Reference 3

Previous Employer

Company 4

Date 4

Empty 'End date' values will use the 'Start date' values.

Date

E.g., 06/27/2020

to:

Date

E.g., 06/27/2020

Job Duties 4

Reason for Leaving 4

Contact for Reference 4

Previous Employer

Company 5

Date 5

Empty 'End date' values will use the 'Start date' values.

Date

E.g., 06/27/2020

to:

Date

E.g., 06/27/2020

Job Duties 5

Reason for Leaving 5

Contact for Reference 5

If you have construction experience, please indicate your specific skills

5 / 8

Step 6 of 8 Employment Insurance

Are you currently receiving E.I. benefits? *

Yes

No

Do you have enough hours to file for an E.I. claim? *

Yes

No

Have you received E.I. benefits within the last three (3) years? *

Yes

No

Have you had training through HRDC or MTCU in the past? *

Yes

No

If yes, when?

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Step 7 of 8 Criminal Convictions

Have you ever been convicted or found guilty by a court of any criminal offence in any country? *

Yes

No

Are there any criminal actions pending against you in any country? *

Yes

No

If yes, please explain (charges, date, country, etc.)

7 / 8

Step 8 of 8 Garnishments

Do you owe any amount to the Government of Canada under legislation or contribution agreements? *

Yes

No

(i.e. arrears for child support payments, E.I. overpayments, income tax, etc.)

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Labourers' Union Local 1059 • 635 Wilton Grove Road • London, ON • N6N 1N7 LiUNA is an equal opportunity employer, and is committed to providing required accommodations to persons with disabilities, including during the recruitment, selection and hiring process. View our accessibility plan. © Copyright 2019 LIUNA Local 1059, All Rights Reserved. Admin Login

In order to help mitigate the spread of COVID-19, LiUNA Local 1059 is closed until further notice. Our staff is working remotely, and service will continue.

MEMBERS: CLICK HERE FOR EVERYTHING YOU NEED TO KNOW ABOUT YOUR EMPLOYMENT & COVID-19

About
Membership
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Contact

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About
Membership
Apprenticeships & Courses
Home
Training Centre & Facilities
Links & Resources
Contact