Personal Support Worker no Resume

First Name

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Last Name

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Address

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City

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Province

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Postal Code*

Country

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Home Phone # (555-555-5555)

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Cell #

E-mail Address

Re-type e-mail address

Main intersection closest to your home.

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Where are you willing to work?

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Downtown Toronto East York Scarborough North York York Region Durham Region Etobicoke

A person legally eligible to work in Canada is a Canadian citizen, a landed immigrant, permanent resident or a holder of a valid work permit.

Are you legally eligible to work in Canada?

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Yes No

Have you ever been convicted of a criminal offence for which you have not been pardoned?

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Yes No

Some positions require access to a car, valid driver's license and car insurance.

Do you use public transportation for work?

Yes No

Do you have access to a car?

Yes No

Do you have a valid driver's license and car insurance?

Yes No

Please indicate the position you are applying for

Personal Support Worker Home Support Worker Cleaner

Ideally how many hours per week would you like to work?

When are you available to Start?

Please indicate your availability.

Monday

Early Morning (6 am - 9 am) Late Morning (9 am - noon) Afternoon (Noon - 6 pm) Evening (6 pm - 11 pm) Over Night (11 pm - 7 am)

Tuesday

Early Morning (6 am - 9 am) Late Morning (9 am - noon) Afternoon (Noon - 6 pm) Evening (6 pm - 11 pm) Over Night (11 pm - 7 am)

Wednesday

Early Morning (6 am - 9 am) Late Morning (9 am - noon) Afternoon (Noon - 6 pm) Evening (6 pm - 11 pm) Over Night (11 pm - 7 am)

Thursday

Early Morning (6 am - 9 am) Late Morning (9 am - noon) Afternoon (Noon - 6 pm) Evening (6 pm - 11 pm) Over Night (11 pm - 7 am)

Friday

Early Morning (6 am - 9 am) Late Morning (9 am - noon) Afternoon (Noon - 6 pm) Evening (6 pm - 11 pm) Over Night (11 pm - 7 am)

Saturday

Early Morning (6 am - 9 am) Late Morning (9 am - noon) Afternoon (Noon - 6 pm) Evening (6 pm - 11 pm) Over Night (11 pm - 7 am)

Sunday

Early Morning (6 am - 9 am) Late Morning (9 am - noon) Afternoon (Noon - 6 pm) Evening (6 pm - 11 pm) Over Night (11 pm - 7 am)

Anything else you want to tell us about your availability?

In addition to English, please list all the languages you:

Speak

Understand

Write

Have you ever been employed by VHA?

Yes No

If yes:

Employment dates

From (mm/yyyy):

To (mm/yyyy):

What was your position?

What was your reason for leaving?

EDUCATION

Please indicate your highest level of education

Area(s) of Specialization

Additional Courses, Seminars, Workshops, Skills, Experience, Training

EMPLOYMENT EXPERIENCE

Employer Name

Employment Dates

From (mm/yyyy):

To (mm/yyyy):

Position

Duties and Responsibilities

Supervisor's Name and Title

Contact Information (telephone # and/ or email address)

VHA Home HealthCare is authorized to obtain a reference from the above employer

Yes

No

Employer Name

Employment Dates

From (mm/yyyy):

To (mm/yyyy):

Duties and Responsibilities

Supervisor's Name and Title

Contact Information (telephone # and/ or email address)

VHA Home HealthCare is authorized to obtain a reference from the above employer

Yes No

Employer Name

Employment Dates

From (mm/yyyy):

To (mm/yyyy):

Duties and Responsibilities

Supervisor's Name and Title

Contact Information (telephone # and/ or email address)

VHA Home HealthCare is authorized to obtain a reference from the above employer

Yes No

Employer Name

Employment Dates

From (mm/yyyy):

To (mm/yyyy):

Duties and Responsibilities

Supervisor's Name and Title

Contact Information (telephone # and/ or email address)

VHA Home HealthCare is authorized to obtain a reference from the above employer

Yes No

Where did you hear about this opportunity?

Other

Disclaimer:

By checking 'I agree' I certify that the information provided in this profile is true and complete to the best of my knowledge. I understand that a false statement or omission may disqualify me from employment, or cause my dismissal.

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I agree