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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
Support Worker - Intentional Community (Chilliwack)
Registered Nurse
Are you legally able to work in Canada?
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Yes
No
Advertisement Reference # (if applicable)
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 (L)
BC Class 7 (N)
BC Class 6 or 8 ONLY
Out-of-province
Out-of-country
Are you currently registered with BCCNM?
Yes
No
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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
Bethesda Website
Castanet
Church
College/University
CommunityLivingCareers.ca website
Craigslist
Facebook
Family/Friend
Google Search
Inclusion BC
Indeed
Job Fair
Newspaper
Radio
WorkBC
Workinnonprofits
Other
What type of service(s) would you like to work in? (check all that apply)
I am open to any services
Community Inclusion (Abbotsford, Chilliwack, Langley)
Staff Supported Home (Abbotsford, Chilliwack, Kelowna, Ladner, Langley, Maple Ridge, Penticton, Richmond, Surrey)
Supported Independent Living (Abbotsford, Chilliwack)
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Do you hold a Canadian CPA designation
Yes
No
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