Job Application Form * indicates a required field PERSONAL DETAILS Full Name*i Please provide your given and legal full name Email* Main Telephone* Mailing Addressi Please provide your full mailing address AVAILABILITY Availability Status*i Please indicate if you interested in full or part-time work or both Full-time Part-time Earliest Start Date*i Indicate when your earliest start date would be Days and Shifts Available*i Please indicate which days and shifts you are available to work All Day Day Time Night Time Overnight Not Available Monday Tuesday Wednesday Thursday Friday Saturday Sunday EDUCATION & QUALIFICATIONS Highest level of education completed * High School College University Post-Graduate Other Name of educational institution Location of educational institution Highest level of accreditation achieved* Certificate Diploma Bachelor Degree Masters Other Title of accreditation Other Training and Certificatesi Specify other training and certificates you have successfully completed Valid Driver's License* Yes No Reliable access to a vehicle* Yes No Experience with: * Please check all that apply Housekeeping Food preparation Activities planning Administration of medications Nursing Dementia Diabetes Cancer Depression Other mental health Autism Osteoporosis Palliative Care / Wheelchair transport Multiple Sclerosis Alzheimer’s Parkinson's RESUME Your Resume (Optional) Please upload your resume in Word, Open Office, PDF, JPG, or PNG formats only (max. 5MB) PERSONAL SUITABILITY QUESTIONS Working with Pets Comfortable with cats Comfortable with dogs Comfortable with other domestic animals Not comfortable work with animals Other Languages Spoken* Besides English, what other languages are you able to speak? Why you are you interested in looking after an elderly? * In 500 words or less Why should we hire you? * In 500 words or less Human Check 2 + 0 =
