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Full Name
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First Name
Middle Name/Initial
Last Name
Phone Number
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Area Code
Phone Number
E-mail
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Which Position are you applying for?
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Support Worker
Registered Nurse (Kelowna)
Other position
Are you legally able to work in Canada?
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Yes
No
How many hours per week are you available to work?
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Less than 20 hours
20-30 hours
31-40 hours
Are you willing to do shift-work (Days, Evenings, and Nights)?
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Yes
No
Where are you willing to work (check all that apply)
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Abbotsford
Chilliwack
Kelowna
Ladner/Delta
Langley
Maple Ridge
Penticton
Richmond
Surrey
What type of driver’s license do you hold?
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No license
BC Class 1 or 2
BC Class 3 or 5
BC Class 4
BC Class 7 (Learners)
BC Class 6 or 8 ONLY
Out-of-province
Out-of-country
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If you were referred by a current Bethesda employee, please provide their full name:
Where did you hear about this job opportunity at Bethesda? (Check off all that apply)
Bethesda staff member
Castanet
Church
College/University
CommunityLivingCareers.ca website
Craigslist
Facebook
Family/Friend
Inclusion BC
Indeed
Internet Search
Job Fair
Newspaper
Radio
SupportworkerBC
WorkBC
Workinnonprofits
What type of service(s) would you like to work in? (check all that apply)
I am open to any services
Children's Respite (Abbotsford)
Community Inclusion (Abbotsford, Chilliwack, Langley, Surrey)
Staffed Residential (Abbotsford, Chilliwack, Kelowna, Ladner, Langley, Maple Ridge, Penticton, Richmond)
Supported Employment (Abbotsford)
Supported Independent Living (Abbotsford, Chilliwack)
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