Spiritability Hiring Campaign

Job Application - Homecare Disability Support Worker

Your Personal Information

Your Name
Address
Upload your resume in .pdf, .doc or .docx format
Accepted file types: pdf, doc, docx, Max. file size: 25 MB.
Upload your resume in .pdf, .doc or .docx format
Accepted file types: pdf, doc, docx, Max. file size: 25 MB.

Work History

Previous Employer
Please list your previous employers, the dates you worked and the position you held
Employer
Dates
Position
Responsibilities
 

Education History

Current First Aid/CPR
Max. file size: 128 MB.

Skills and Qualifications

Medical History

Do you have any medical conditions or disabilities that may affect your ability to perform the essential functions of the Disability Support Worker role?
Are you currently taking any medications that may impact your ability to perform essential duties of the job safely?
Have you ever been diagnosed with a condition that may require accomodations or modifications in the workplace?

Availability

Hours You Are Available for Work
Please tell us what hours you are available for work each day of the week.
Monday
Tuesday
Wednesday
Thursday
Friday
 
Are you available for early morning shifts?
Are you available for evening shifts?
Are you available for sleepovers?
Are you available for active night shifts?

References

Reference 1
Name
Job Title
Company
Phone
Email
 
Reference 2
Name
Job Title
Company
Phone
Email
 

Driving Record

Speeding fine in the past 3 years?
Accidents where you were driving past 3 years?
Were you the driver at fault on any occasion?
Max. file size: 128 MB.

Background Checks

Please provide details of any relevant background checks you have completed or are currently undertaking. These checks may include, but are not limited to, the following:

Signature and Date

Please note that providing accurate and up-to-date information regarding your background checks is essential for consideration for this position. Failure to disclose relevant information may affect your application. I certify that the information provided in this application is accurate and complete to the best of my knowledge.
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