Contract Caregiver Application
We are currently looking for Contract Caregivers to provide essential assistance to seniors within the comfort of their own homes. As a contract caregiver, you will be responsible for ensuring the well-being, safety, and overall quality of life for our valued clients.
Name
First Name
Last Name
Phone Number
E-mail
example@example.com
Total years experience with Senior in home care:
Do you have a PSW or higher equivalent?
Please provide which certification
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth
-
Month
-
Day
Year
Date
I am have or am willing to provide proof of (check all that apply):
Bonded and Insured
Criminal Record check
Valid Drivers license
Vehicle proof of Insurance
Are you legally able to work in the Canada?:
Yes
No
Do you consent to a Background check?:
Yes
No
Comfortable commuting?:
Name areas you are willing to commute to.
Distance Willing To Travel?
Please Select
Over 35km Radius
Below 35km Radius
Public Transit Only
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Employment Desired:
Date You Can Start
-
Month
-
Day
Year
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Position Interested In (check all that apply):
Full Time
Part Time
Temporary
On Call
Overnight 12hr max
Live in
Please indicate preferred schedule
Days, Times etc
Skills/Qualifications:
Introduce yourself to a prospective employer by sharing a personal letter about your experience. Include qualities that make you an outstanding caregiver and why you've chosen this profession:
This opportunity holds far more significance than just a job for us. We seek contract caregivers who appreciate the importance of being embraced by a family to provide care for their elderly loved ones. Furthermore, we place significant importance on receiving professional communications crafted with meticulous attention to detail.
What skills and experience do you have that are useful in being a Senior caregiver? Feel free to be as in depth as possible.
List any additional health & safety trainings:
CPR, Dementia care etc
Include links to your social media profiles, so we can get to know you better:
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Education:
High School
Name of High School Attended
Graduated?
Please Select
Yes
No
College
Name of College/University Attended
Graduated?
Please Select
Yes
No
Graduate School
Name of College/University Attended
Graduated?
Please Select
Yes
No
Trade School
Name of College/University Attended
Graduated?
Please Select
Yes
No
Specific area of Study/Degree if any
List of other professional training:
i.e. STARS, NCS, Doula training, conference workshops, etc.
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Mandatory Job History
Current Employer Name
*
i.e. Name of Family
Location & Phone number
i.e. Neighborhood
Current Employer Start Date
-
Month
-
Day
Year
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Current Employer End Date
-
Month
-
Day
Year
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Position
Your job title
May We Contact?
*
Yes
No
Current Employer Duties
Please include an in-depth job description
Previous Employment
Previous Employer
*
i.e. Name of Family
Location & Phone number
i.e. Neighborhood
Previous Employer End Date
-
Month
-
Day
Year
Date Picker Icon
Position
Your job title
May We Contact?
*
Yes
No
Previous Employer Duties
Please include an in-depth job description
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References:
Please include at least three
Please list personal references with phone numbers or email.
May we contact your references?
*
Yes
No
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Cover Letter & Resume:
Please Upload Your Cover Letter
Upload a File
Drag and drop files here
Choose a file
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Please Upload Your Resume
Upload a File
Drag and drop files here
Choose a file
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Acknowledgement
I have uploaded my resume. Without a resume, I understand that my application may not be considered.
Submit
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