Comfort Keepers of Peterborough Application Form

Application Form

We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including race, color, age sex, religion, disability, medical condition, national origin, or marital status.

Personal Information

First Name *

Last Name *

Home Phone *

Work Phone

Mobile Phone

Email *

Address 1 *

Address 2

City *

Province

Postal Code *

Driver's License Number

Section 1 - General Information

Position(s) Applying For: (required)

How did you hear about us? (If unknown, please write N/A) (required)

What is your preferred method of contact? (required)

When is the best time to contact you? (required)

What other language(s) are you fluent in?

Section 2 - Educational Background

Do you have a High School Diploma/GED? (required)

Yes No

Do you have a College Diploma or University Degree? (required)

Yes No

Do you hold a valid Canadian PSW (or equivalent) qualification? (required)

Yes No

Effective Date *

Section 3 - Employment Information

What date are you available for Employment? (required)

Section 4 - Resume

Please use this space to copy and paste your resume, or a portion thereof. Submission of a resume is not an alternative to completing this form. Only complete applications will be considered. You may also choose to add comments and other Skills, licenses/certification and qualifications (including explanation of any gaps in employment).

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Section 5 - Reference 1

Name: (required)

Telephone Number (required)

(Numeric Answer Only)

Years Known? (required)

(Numeric Answer Only)

Relationship? (required)

Section 6 - Reference 2

Name:

Telephone Number

(Numeric Answer Only)

Years Known

(Numeric Answer Only)

Relationship

Section 7 - Reference 3

Name:

Telephone Number

(Numeric Answer Only)

Years Known

(Numeric Answer Only)

Relationship

Section 8 - Professional/Personal

Have you been double vaccinated against Covid? (required)

Yes No

What brings you joy? (required)

Section 9 - Pay Rate

Starting pay range: $16.00-$17.50 hourly

I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.

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