Employment Application Form - Support Worker or Registered Nurse; Other Position

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Full Name *

First Name Middle Name/Initial Last Name
Phone Number *

Area Code Phone Number
E-mail *
Which Position are you applying for? *

Support Worker Registered Nurse (Kelowna) Other position
Are you legally able to work in Canada? *

Yes No
How many hours per week are you available to work? *
Are you willing to do shift-work (Days, Evenings, and Nights)? *

Yes No
Where are you willing to work (check all that apply) *

Abbotsford Chilliwack Kelowna Ladner/Delta Langley Maple Ridge Penticton Richmond Surrey
What type of driver’s license do you hold? *
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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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