Caregiver

Work Preferences

• Mornings (7am - 1 pm)
• Days (9am-6pm)
• Evenings (3pm-11pm)
• Night Shifts (9pm - 9am)
• Sleepshifts (9pm - 9am - able to get 6 hours of sleep)
• Part Time 6-35 hours per week
• Full Time 35-44 hours per week

Availability

Please indicate what days you are available to work:

Hours Desired

Number of hours you would ideally like to work weekly?

Geographic Area

What geographic area(s) would you like to work in?

Training and Experience

What is your highest level of caregiver training and experience?

• Caregiver - Limited Experience
• Caregiver - Extensive Personal Experience
• SSWG / DSW / CSW / PTA / OTA
• PSW - or Equivalent (Nursing Student 1+ year)
• Nurse - RPN or RN (Licensed)
• Other

References

• Professional References: Please list three (3) people (who are not related to you) including prior supervisors who can provide a professional reference.
• Personal References: Please list three (3) people (who are not related to you) who can provide a personal reference.

Additional Information

Please elaborate on your formal education. List diploma's/degrees achieved/obtained including year completed.

What training or experience do you have working with the elderly? (Either formal or informal)

What do you like most about working with the elderly?

What do you like least about working with the elderly?

Have you ever been convicted of an offence for which a pardon has not been granted?

Date Available to Start

Salary or Wage expectations (hourly)

Please provide a summary as to why you think you would make an outstanding addition to our team / caregiver?

• Please indicate your level of experience and proficiency in meal preparation for seniors.
• Please indicate your level of experience and proficiency in providing the following home maintenance activities for seniors. Vacuuming, Dusting, Cleaning - Bathrooms and Kitchens, Bed Linen Changes, Laundry and Ironing.
• All clients are different, when it comes to providing companionship, please describe yourself.
• Please indicate your level of experience and proficiency in providing the following activities for seniors. Errands, Transportation, Grocery Shopping either for or with a senior client.

Application Details

We are interested to know how you found us. Please tell us your source below:

CERTIFICATION AND RELEASE: By electronically submitting this application I certify that I have read and understand the application and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions, or misrepresentation of facts called for in this application may result in rejection of my application or discharge at any time during my employment. I authorize the company and/or its agents, including consumer reporting bureaus, to verify any information including, but not limited to, criminal history and motor vehicle driving records. I authorize all persons, schools, companies, and law enforcement authorities to release any information concerning my background and hereby release any said persons, schools, companies, and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I also understand that the use of illegal drugs or alcohol is prohibited during employment. Should I report to work intoxicated or found to be using drugs or alcohol while on the job, the company may terminate my employment for serious reasons, without further compensation, notice or delay.

Would you be willing to take a drug test?