Caregiver Applicant Form

Personal Information

* First Name

*Last Name

* Email

* Address Line 1

Address Line 2

* Country

* State/Province

* City

* Zip/Postal Code

*Gender

* Mobile Phone

* Home Phone

*Date of Birth

* SIN

Educational Background New Educational Background

School/College/University

Qualification

Attach Document

Certifications

CPR

Browse

Driver's License

Browse

First Aid

Browse

Employment History New Employment History

Please provide your latest employer information below.

Employer Name

Phone Number

Address

Country

State/Province

City

Zip/Postal Code

Served From

Served To

Position Held

Attach Document

References New Reference

Name

Phone Number

Miscellaneous Questions

Q.) What do you find most rewarding about being a care companion? If you are new to the role, why are you interested in being a care companion?

Q.) What is you work availability?

Q.) What steps do you take to ensure the dignity and respect of the individual(s) that you care for?

Q.) What do you believe are the most important qualities or characteristics of a successful employee, and how do you embody those qualities?

Q.) A vehicle is required for this position with $2 million liability on you personal auto insurance, are you able to comply with this?

Q.) REQUIRED: First aid + CPR are required within 30 days of hire. Are you able you comply with these requirements?

Q.) REQUIRED: A vulnerable sector check, and a clean criminal record check must be provided prior to your first shift if hired. Are you able to comply with these requirements?

Q.) Are you willing to complete paid training if you are hired?

Caregiver Application Form

Personal Information

Educational Background New Educational Background

Certifications

Employment History New Employment History

Skills/ Preferences

References New Reference

Miscellaneous Questions

* Caregiver Signature