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Thank You For Your Interest To Join Our Team

Please Fill Out And Submit The Following Application Forms.
Please Attach Copies Of The Following: Police Clearance, Vulnerable Sector Care Approval, Current Resume
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1 Step 1
First
Middle Name
Last Name
Address
Address 2
City
Postal Code
Home Phone
Mobile Phone
Are You Eligible To Work In Canada?pick one!
Please select checkboxes that match your skills and preferences.
General
Cooking - Canadian
Cooking - Ethnic
Cooking - No Experience
Driver - Will Drive client
Driver - Will Not Drive Client
Experience - Dementia
Experience - Diabetes
Experience - Incontinence
Experience - Medication Mgmt
Experience - Palliative Care
Experience - Swallowing Precautions
Gender
Transfers
Pets
Allergy to Animals
Will Accept Client with Pets
Will Accept Clients who Smoke
Education & Training:
High School
College School:
Degree/Cerificate received:
Certifications and Credentials:
Please check all that apply, and enter the expiration date and any notes as applicable.
Active
Type
Expiration Date
Notes
Annual anniversary (date of hire)
Expiry Date
date_range
Note
Car Insurance
Expiry Date
date_range
Note
Copy of SIN
Expiry Date
date_range
Note
CPR Certification
Expiry Date
date_range
Note
Criminal Record Check
Expiry Date
date_range
Note
Driver's License
Expiry Date
date_range
Note
Drivers Abstract
Expiry Date
date_range
Note
Flu Shot 2015
Expiry Date
date_range
Note
HCA Certificate
Expiry Date
date_range
Note
LVN/LPN Certification
Expiry Date
date_range
Note
Out of Country Credentials
Expiry Date
date_range
Note
Performance Evaluation
Expiry Date
date_range
Note
Proof of 3rd Party liability coverage
Expiry Date
date_range
Note
Work Permit
Expiry Date
date_range
Note
Employment History
Please provide your most recent positions of employment.
Employer
Supervisor
Phone Number
Date Employed
date_range
Address
Employer
Supervisor
Phone Number
Date Employed
date_range
Professional References:
Please provide professional references :
Name
Phone Number
Name
Phone Number
Name
Phone Number
AVAILABILITY


Due to the nature of this Job,You Understand And Agree That 24/7 Home Support And Care ade as to the schedule or the amount of hours worked.

What date are you available to begin work?
date_range
Please complete all areas of availability
Mornings
Afternoon
Evenings
Overnights
Weekdays
Weekend
Please indicate the days of the week as well as the earliest and latest times that you are available for work.
From
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
To
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
PREFERENCES
Please indicate all areas of the city in which you are willing to work:
Please indicate the types of services which you are willing to provide
*Due to the nature of our job, your availability will greatly impact the opportunities we can offer you. We advise you to provide your updated availability.
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