Excel Care Job Application

1
Name
First Name
Last Name
2
Address
Street Address
Street Address Line 2
City
State
Zip Code
Canada
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
3
Phone Number
Area Code
Phone Number
4
Email
example@example.com
5
Position Applying For
Personal Support Worker
Health Care Aide
Registered Practical Nurse
Registered Nurse
Scheduler
6
Shift Availability
Mon
Tues
Wed
Thurs
Fri
Sat
Sun
DAY SHIFTS
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Row 0, Column 5
Row 0, Column 6
EVENING SHIFTS
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Row 1, Column 4
Row 1, Column 5
Row 1, Column 6
NIGHT SHIFTS
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
Row 2, Column 4
Row 2, Column 5
Row 2, Column 6
DAY SHIFTS
EVENING SHIFTS
NIGHT SHIFTS
Mon
Row 0, Column 0
Tues
Row 0, Column 1
Wed
Row 0, Column 2
Thurs
Row 0, Column 3
Fri
Row 0, Column 4
Sat
Row 0, Column 5
Sun
Row 0, Column 6
Mon
Row 1, Column 0
Tues
Row 1, Column 1
Wed
Row 1, Column 2
Thurs
Row 1, Column 3
Fri
Row 1, Column 4
Sat
Row 1, Column 5
Sun
Row 1, Column 6
Mon
Row 2, Column 0
Tues
Row 2, Column 1
Wed
Row 2, Column 2
Thurs
Row 2, Column 3
Fri
Row 2, Column 4
Sat
Row 2, Column 5
Sun
Row 2, Column 6
1 of 3
7
What is your expected hourly pay rate?
8
Professional References* This field is required.Please provide most recent references
Reference Name
Relationship
Company
Telephone #
Reference 1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Reference 2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Reference 1
Reference 2
Reference Name
Row 0, Column 0
Relationship
Row 0, Column 1
Company
Row 0, Column 2
Telephone #
Row 0, Column 3
Reference Name
Row 1, Column 0
Relationship
Row 1, Column 1
Company
Row 1, Column 2
Telephone #
Row 1, Column 3
1 of 2
9
Todays Date
Date
Year
Month
Day
10
Upload Resume* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
11
Please Read Carefully I hereby declare that the foregoing information and the resume I submitted (if applicable) true and complete to the best knowledge. I understand that a false statement may disqualify me from employment or cause my dismissal for cause.
Clear
12
Where did you hear about us?
Excel Care Website
Indeed
Other
13
Location
Toronto
Etobicoke
Scarborough
Mississauga
Oakville
Waterloo
Burlington
Kitchener
Cambridge
14
Additional Notes
Huge
Large
Normal
Small
Ok
Ok
15
Thank you for applying with us here at Excel Care. We look forward to working together.

We know that during these unsettling times with COVID, there have been shifts in how the HealthCare Industry operates, and we appreciate your willingness to adapt to these times with us. HealthCare facilities and the general public require stricter onboarding processes, which means care givers and nurses are required to wait 1-14 days before hire for all health procedures are complete before admission to work in the facility. As you join our team, we appreciate your patience as we ensure the safety of our patients by following our health and safety protocols.

We plan to continue to serve the vulnerable with your help, and your courage to help does not go unnoticed.

We look forward to caring for our community together.

With sincere thanks,

The Excel Care Team
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