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sprice/Government of Canada personal information form

Created September 20, 2010 00:54
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Government of Canada personal information form
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" lang="en" xml:lang="en">
<head>
<title>
Personal Information
</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
<link rel="schema.dc" href="http://purl.org/dc/elements/1.1/" />
<link rel="schema.dcterms" href="http://purl.org/dc/terms/" />
<meta name="dc.title" content="Public Service Resourcing System" />
<meta name="dc.creator" content="Public Service Commission, Staffing and Assessment Services Branch" />
<meta name="dc.language" scheme="ISO639-2/T" content="eng" />
<meta name="dcterms.issued" scheme="W3CDTF" content="2008-09-18" />
<meta name="dcterms.modified" scheme="W3CDTF" content="2010-09-15" />
<meta name="dc.subject" scheme="gccore" content="jobs; employment opportunities; recruiting; labour force; application for employment" />
<link href='/psrs-srfp/css/base-baseInst-inst-pf.css' rel="stylesheet" type="text/css" />
<style type="text/css" media="all">@import url("/psrs-srfp/css/base2.css");</style>
<link rel="shortcut icon" href="/psrs-srfp/images/favicon.ico" type="image/vnd.microsoft.icon" />
<link rel="icon" href="/psrs-srfp/images/favicon.ico" type="image/vnd.microsoft.icon" />
<script type="text/javascript" src="/psrs-srfp/javascript/genericFunctions.js"></script>
</head>
<body
onload="goToAnchor('ancMsg');"
>
<div class="page"><div class="core">
<div class="fip"><a name="tphp" id="tphp"><img src="/psrs-srfp/images/sig-eng.gif" width="390" height="20" alt="Public Service Commission" /></a></div>
<div class="cwm"><img src="/psrs-srfp/images/wmms.gif" width="83" height="20" alt="Symbol of the Government of Canada" /></div>
<div class="banner">
<img src="/psrs-srfp/images/lffl.gif" class="lf pngfix" height="65" width="65" alt="Public Service Commission" />
<p class="main">Careers in the federal public service</p>
<p class="siteuri">jobs.gc.ca</p>
</div>
<div class="navaid">
<a href="#cont">Skip to content</a>
</div>
<div class="fp">
<h1 class="navaid">Common menu bar links</h1>
<ul class="commonbar">
<li class="fiptexta"><div><a href="/psrs-srfp/applicant/1/page1190?toggleLanguage=fr" lang="fr" xml:lang="fr" title="Fran&ccedil;ais - Version fran&ccedil;aise de cette page">Fran&ccedil;ais</a></div></li>
<li class="fiptext"><div><a href="http://jobs-emplois.gc.ca/index-eng.htm" title="Home">Home</a></div></li>
<li class="fiptextc"><div><a href="http://jobs-emplois.gc.ca/centres/contact-eng.htm#psrs" title="Contact Us - This link opens in a new window." onclick="javascript:try{if(openWindow('http://jobs-emplois.gc.ca/centres/contact-eng.htm#psrs')!=null)return false;}catch(err){return true;}return true;">Contact Us</a></div></li>
<li class="fiptext"><div><a href="/psrs-srfp/applicant/page100080?helpBackAction=%2Fpsrs-srfp%2Fapplicant%2F1%2Fpage1190&#38;helpPage=help/enterPersonalData.jsp" title="Help">Help</a></div></li>
<li class="fiptext"><div><a href="http://jest-orae.psc-cfp.gc.ca/JEST-ORAE/qcksrch.do?lang=en" title="Search">Search</a></div></li>
<li class="fiptextb"><div><a href="http://www.canada.gc.ca/home.html" title="canada.gc.ca - Government of Canada Web site">canada.gc.ca</a></div></li>
</ul>
</div>
<p class="breadcrumb"><a href="http://jobs-emplois.gc.ca/index-eng.htm">Home</a> &gt; </p>
<div class="center">
<a name="cont" id="cont"></a>
<h1>Personal Information</h1>
<p class="mandatory">Required fields are marked with an asterisk (<abbr class="mandatory" title="Required">*</abbr>).</p>
<form action="page1190" method="post" enctype="application/x-www-form-urlencoded">
<div class="formContent">
<input type="hidden" name="isInProfile" value="" />
<div class="labelControl">
<label for="last_name">
<abbr class="mandatory" title="Required">*</abbr>
Last Name:
</label><br />
<input type="text" name="last_name" value="" id="last_name" size="61" maxlength="60" class="focusHighlight" />
</div>
<div class="labelControl">
<label for="first_name">
<abbr class="mandatory" title="Required">*</abbr>
First Name:
</label><br />
<input type="text" name="first_name" value="" id="first_name" size="61" maxlength="40" class="focusHighlight" />
</div>
<div class="labelControl">
<label for="mdl_init">
Initials:
</label><br />
<input type="text" name="mdl_init" value="" id="mdl_init" size="4" maxlength="3" class="focusHighlight" />
</div>
<div class="labelControl">
<label for="email">
<abbr class="mandatory" title="Required">*</abbr>
E-Mail Address:
</label><br />
<input type="text" name="email" value="" id="email" size="61" maxlength="60" class="focusHighlight" />
</div>
<div class="labelControl">
<label for="available_date">
<abbr class="mandatory" title="Required">*</abbr>
Date Available: <span class="nobold"><acronym title='Year'>YYYY</acronym>-<acronym title='Month'>MM</acronym>-<acronym title='Day'>DD</acronym></span>
</label><br />
<input type="text" name="available_date" value="" id="available_date" size="11" maxlength="10" class="focusHighlight" />
</div>
<div class="labelControl">
<fieldset class="autoFitFieldset">
<legend>Partial Birth Date</legend>
<div class="labelControl">
<label for="birth_year_date">
<abbr class="mandatory" title="Required">*</abbr>
Year (last digit):
</label><br />
<select name="birth_year_date" size="1" id="birth_year_date">
<option value="" selected="selected">Please Specify</option>
<option value="0">0</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
</select>
</div>
<div class="labelControl">
<label for="birth_month_date">
<abbr class="mandatory" title="Required">*</abbr>
Month:
</label><br />
<select name="birth_month_date" size="1" id="birth_month_date">
<option value="" selected="selected">Please Specify</option>
<option value="1">January</option>
<option value="2">February</option>
<option value="3">March</option>
<option value="4">April</option>
<option value="5">May</option>
<option value="6">June</option>
<option value="7">July</option>
<option value="8">August</option>
<option value="9">September</option>
<option value="10">October</option>
<option value="11">November</option>
<option value="12">December</option>
</select>
</div>
<div class="labelControl">
<label for="birth_day_date">
<abbr class="mandatory" title="Required">*</abbr>
Day:
</label><br />
<select name="birth_day_date" size="1" id="birth_day_date">
<option value="" selected="selected">Please Specify</option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
</div>
</fieldset>
</div>
<div class="labelControl">
<label for="citizenship">
<abbr class="mandatory" title="Required">*</abbr>
Citizenship:
</label><br />
<select name="citizenship" size="4" id="citizenship">
<option value="1">Canadian Citizen</option>
<option value="2">Permanent Resident</option>
<option value="3">Work Permit</option>
<option value="4">Other</option>
</select>
</div>
<div class="labelControl">
<label for="psea_ind">
Are you currently employed by the Public Service of Canada? (For statistical purposes only):
</label><br />
<select name="psea_ind" size="3" id="psea_ind">
<option value="nothing">Please Specify</option>
<option value="true">Yes</option>
<option value="false">No</option>
</select>
</div>
<div class="labelControl">
<label for="pri">
Personal Record Identifier (<acronym title='Personal Record Identifier'>PRI</acronym>): (Issued only to individuals who are employed by the public service of Canada)
</label><br />
<input type="text" name="pri" value="" id="pri" size="9" maxlength="8" class="focusHighlight" />
</div>
<div class="labelControl">
<label for="popupIndicator">
Select here if you want to use popup windows:
</label>
<input type="checkbox" name="popupIndicator" value="true" checked="checked" id="popupIndicator" />
</div>
<p>Note: If you remove the option for using popup windows, you must always Save your responses before you access Help or change the language of the screen from English to French. Failure to save the responses you have just completed will result in the information being lost.</p>
<div class="rightElement"><input type="submit" name="Continue" value="Continue" class="btn"/></div>
<div class="leftElement"><input type="submit" name="Back" value="Back" class="btn"/></div>
</div>
</form>
</div><div class="footer">
<div class="footerline"></div>
<div class="foot1">Date Modified: <span class="date">2010-09-15</span>
</div><div class="foot2"><a href="#tphp" title="Return to Top of Page"><img class="uparrow" src="/psrs-srfp/images/tphp.gif" width="19" height="12" alt="Top of Page" /><br />Top of Page</a></div>
<div class="foot3"><a href="http://jobs-emplois.gc.ca/common-commun/notices-avis-eng.htm" title="Important Notices">Important Notices</a></div>
</div></div></div></body></html>
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