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Submit a Form to Apply Today! Your Personal Information Your Name (Required) First Last Address (Required) Street Address Address Line 2 City Province Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Postal Code Your Phone (Required) Your Email Address (Required) Are you legally entitled to work in Canada? (Required) Yes No Are you currently employed? (Required) Yes No Have you previously been employed by Cross Country? (Required) Yes No If yes, when? Have you ever been convicted of a criminal offense for which a pardon has not been granted, or are you waiting for a verdict? (Required) Yes No If yes, when? Do you have reliable means of transportation to get to work? (Required) Yes No Are you 18 years of age or older? (Required) Yes No Would you like to work: (Required) Full Time Part Time Seasonal What areas are you interested in working in? What do you expect for a starting wage? How did you hear about the job opening? Education Name Of High School And Highest Grade Completed Name Of College/University and Level Completed Any other Education/Specialized Training: Previous Employment Your Previous Employers List in order starting with your present or most recent employment. Press + button to add more employers Employer Address Job Title Name & Title Of Supervisor Start / End Dates Phone Reason For Leaving Add Remove May we contact your present or previous employers for reference? (Required) Yes No Upload Your Resume Upload your resume in .pdf, .doc or .docx format Accepted file types: pdf, doc, docx, Max. file size: 25 MB. Terms and Conditions (Required) ACKNOWLEDGEMENT The foregoing statements are correct to the best of my knowledge. I understand that any misrepresentation may disqualify me from employment or be the cause of my dismissal. If hired, I agree to abide by all the rules and regulations of Cross Country, including serving an initial probationary period. I agree to the terms and conditions. Signature (Required) Your Name Your Name Your Name Your Name Date (Required) Submit Application

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