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Choosing a caregiver   Supporting Community
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Employee Application

  1. Please tell us about yourself: * name and phone number are required fields








  2. I have a valid certification in Standard First Aid/CPR Level C
    Completed high school
    Attended post-secondary education
    Completed post-secondary education
    I have a valid WHMIS certification
    I have completed the Continuing Care Assistant(CCA) program
    I am a qualified Personal Care Worker (PCW)
    I am a qualified Personal Support Worker (PSW)
    I am a qualified Home Support Worker (HSW)
    I have a valid licence and a reliable, insured automobile
    I have completed a food handler's certification course
    Palliative Care Course
    Mental Health First Aid
    I have completed an Alzheimer or Dementia care course
    I have recently (within the past three months) had a criminal record check
    I have regular access to email
    I have regular access to telephone
  3. How many years of previous experience do you have as a personal caregiver?

    No previous experience1 month - 1 year of experienceMore than 1 year - 5 years experienceMore than 5 years - 10 years experienceMore than 10 years experience
    Private
    In a facility (i.e. nursing home)
    With a home care agency
  4. Please tell us a little bit more about your availability and expectations



  5. Yes    No  



  6. Casual: on-call
    Part-time: 0-40 hours
    Full-time: 30+ hours
  7. Primary    Supplemental  

  8. Caregivers are expected to be available alternate weekends. Below is an opportunity for you to indicate your general availability. Please indicate all times of day you would be available to work.

       Morning (6am-noon)      Afternoon (noon-5pm)      Evening (5pm-midnight)      Overnight (10pm-8am)   
    Monday
    Tuesday
    Wednesday
    Thursday
    Friday
    Saturday
    Sunday
  9. Yes    No   Other (please specify)