Application for Shift Work
Please note, this application for Shift Work is based on the Memorandum of Agreement: Committee to Address Resident Scheduling Issues. This application must be completed in full before consideration is given to the request. Scheduling must comply with the Collective Agreement until and after a decision is made by the Scheduling Committee.
Program
*
Site
*
Program Director (Applicant)
*
First Name
Last Name
Email
*
example@example.com
Site Director
First Name
Last Name
Email
example@example.com
Program Administrator
First Name
Last Name
Email
example@example.com
Program Scheduler
First Name
Last Name
Email
example@example.com
Residents in the Program approve of this Application?
*
Yes
No
Does your program run regular hours 7 days per week, 24 hours per day?
*
Yes
No
If No, What are the regular daily hours of your program?
*
Does your program schedule Call shifts in addition to regular duty?
*
Yes
No
How many shifts of how many hours are generally scheduled daily?
*
How many Residents are scheduled daily for shifts that cross or start at Midnight?
*
Are Residents scheduled for more than one shift per day?
*
Yes
No
Additional Information:
*
Sample Schedule (please upload)
*
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How frequently does your schedule differ from the attached?
*
How frequently is this schedule likely to change?
*
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