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Interested in Joining Our Team?

Please complete the form at right or email us your resume. Or download a PDF version here that you can fill in online, or print and fax the completed form back to us at our fax no. 905-524-5999. To get Adobe Acrobat reader, click here.

Application for Employment (* indicates required information)

Position applied for:

Date available:

Salary expected:

Please indicate the shifts for which you are available:

Days

Evenings

Nights

Weekends

Personal Information

*Name:

Street Address:

Apt No.:

City/Town:

Postal Code:

Province

*Home Phone:

Business Phone:

Cell Phone:

*Email address:

Are you legally eligible to work in Canada? Yes No

Have you ever been convicted of a criminal offence for which you have not been pardoned?
Yes No

If yes, specify:

Education: Secondary School

Highest grade completed:

Certificate, License, Diploma awarded?
Yes (List below) No

Education: Community College

Name of Program:

Length of Program:

Diploma / Certificate:

Education: University
Name of Program:

Length of Program:

Major Subject:

License / Certificate / Degree:

Please note: A College of Nurses Registration Number and Police Check will be required if you application is accepted.
Additional Skills & Experience
Describe any of your work related skills, experience or training that relate to the position being applied for:
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Employment History Please enter your present or most recent place of employment first and continue in sequence.

Employer 1:
Address:
Telephone:
Position:
Employed from: to:
Immediate Supervisor:
May we contact?	Yes No
Final Salary:	(hourly)
Reason for leaving:
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Employer 2:
Address:
Telephone:
Position:
Employed from: to:
Immediate Supervisor:
May we contact?	Yes No
Final Salary:	(hourly)
Reason for leaving:
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Employer 3:
Address:
Telephone:
Position:
Employed from: to:
Immediate Supervisor:
May we contact?	Yes No
Final Salary:	(hourly)
Reason for leaving:
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Employer 4:
Address:
Telephone:
Position:
Employed from: to:
Immediate Supervisor:
May we contact?	Yes No
Final Salary:	(hourly)
Reason for leaving:
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Please list any additional courses, skills, interests, hobbies, special qualifications or other experiences that are relevant to the position for which you are applying for:
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Please list any references if different than present/previous employer below:
Reference 1:
Reference 2:

I hereby declare that the foregoing information is true and complete to my knowledge. I understand that false statements may disqualify me from employment, or cause my dismissal. * I agree with this statement. back to top