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job application form
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Application Form
* mandatory fields
GVCSS job reference number [if any]:
*
GVCSS job category:
Home Support
Community Living
Step 1: CONTACT INFORMATION
*
First Name:
*
Last Name:
*
Address:
*
City:
*
Province:
*
Postal Code:
*
Main phone:
Alternate phone:
Email:
*
How did you hear about this position?
Career Fair
Craigslist
HRDC online job bank
GVCSS website
Previous applicant
Former GVCSS employee
Friend
Practicum with GVCSS
Board Member
School/Instructor
Newspaper
Employment Agency
GVCSS employee referral
GVCSS employee referral [if any]:
Step 2: EDUCATION
If selected for an interview, you will need to provide documentary evidence of certificates obtained. Please list most recent education first.
Diploma completed:
College attended:
Dates attended:
Diploma completed:
College attended:
Dates attended:
Diploma completed:
College attended:
Dates attended:
*
All GVCSS employees must be registered on the B.C. Care Aide and Community Health Worker Registry.
No, I have not registered on the Registry.
Yes, I am registered on the Registry.
Here is my BC Care Aide and Community Health Worker registration number:
Step 3: EXPERIENCE [list present or most recent employer first]
Position title:
Employer name:
Dates worked: [from - to]
Description of responsibilities:
Reason for leaving:
Position title:
Employer name:
Dates worked: [from - to]
Description of responsibilities:
Reason for leaving:
Position title:
Employer name:
Dates worked: [from - to]
Description of responsibilities:
Reason for leaving:
Step 4: AVAILABILITY
*
A Community Health Worker is required to work shifts that fall within his /her stated availability, unless changes are made according to the provisions in the 2006 – 2010 Community Subsector Collective Agreement.
If a Community Health Worker is no longer available for the shifts agreed upon at this time, he/she may no longer be entitled to shifts.
Date you are available to start:
Open the calendar popup.
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*
Availability on Mondays:
MORNING 7am-12pm (noon)
AFTERNOON 12pm- 5pm
EVENING 5pm-11pm
OVERNIGHT
LIVE-IN
not available anytime on this day
*
Availabilty on Tuesdays:
MORNING 7am-12pm (noon)
AFTERNOON 12pm- 5pm
EVENING 5pm-11pm
OVERNIGHT
LIVE-IN
not available anytime on this day
*
Availability on Wednesdays:
MORNING 7am-12pm (noon)
AFTERNOON 12pm- 5pm
EVENING 5pm-11pm
OVERNIGHT
LIVE-IN
not available anytime on this day
*
Availability on Thursdays:
MORNING 7am-12pm (noon)
AFTERNOON 12pm- 5pm
EVENING 5pm-11pm
OVERNIGHT
LIVE-IN
not available anytime on this day
*
Availability on Saturdays:
MORNING 7am-12pm (noon)
AFTERNOON 12pm- 5pm
EVENING 5pm-11pm
OVERNIGHT
LIVE-IN
not available anytime on this day
*
Availability on Fridays:
MORNING 7am-12pm (noon)
AFTERNOON 12pm- 5pm
EVENING 5pm-11pm
OVERNIGHT
LIVE-IN
not available anytime on this day
*
Availability on Sundays:
MORNING 7am-12pm (noon)
AFTERNOON 12pm- 5pm
EVENING 5pm-11pm
OVERNIGHT
LIVE-IN
not available anytime on this day
Step 5: COVER LETTER AND RESUME
Attach resume
Step 6: QUESTIONAIRE
*
Do you have a Class 4 Drivers License?
Yes
No
*
Have you been previously employed by GVCSS?
No
Yes
If yes, in which year did you leave GVCSS?
*
What languages are you fluent in (both verbal and written)?
Are there any other experiences, skills, or qualifications which you feel would especially prepare you for this position?
*
As we do have a Nepotism Policy in place, we require applicants to list all relatives and family members working for GVCSS.
Relatives and family members are defined as: spouse, common-law spouse, brother, in-laws, grandparent, grandchild, legal guardian, legal ward, or any other person permanently residing in the same household as you.
No, I do not have any relatives/family members working for GVCSS.
Yes, I do have relatives/family members working for GVCSS.
If yes, what is your relative's name:
Relationship to applicant:
- Select one -
spouse
common-law spouse
parent
child
sibling
in-law
grandparent
grandchild
legal guardian
legal ward
other permanently residing in same household
*
Are you legally entitled to work in Canada?
Yes
No
*
I hereby certify that the information contained in this application is true to the best of my knowledge. I understand that the Employer may conduct or require an investigation on any matters contained in this application and hereby authorize the Employer to do so. I further agree and understand that any false statements made in this application may cause me to forfeit any claims on my part to employment with this organization.
Yes
Submitting...
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