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For quicker response, please fill out the full application form below.
Name
*
First
Last
Address
*
Street
Address
City
Provice
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postcode
Branches
Please tell us which branch you are applying for:
Vancouver / Lower Mainland, BC
Calgary, AB
Edmonton, AB
Comox / Comox Valley, BC
Telephone
*
Cell Phone
Alternate Phone
Email
SIN
Birth Date
Allergies
Languages Spoken
How did you hear about Classic LifeCare?
Website (Google, Indeed, Craigslist, etc)
Friend
Job Fair
Other
Driver's License #
Driver's License Class
Class 5
New / Class 5 GDL
Other
Do you have your own vehicle?
Yes
No
Do you have a valid Driver's License?
Yes
No
Are you comfortable driving a client's vehicle?
Yes
No
Are you comfortable driving a client in your own vehicle?
Yes
No
What have you done that you are most proud of?
Are you willing to work in a smoking environment?
Yes
No
Are you willing to work with pets?
Yes
No
Availability
Are you working right now?
Yes
No
If yes, how much notice will you give your present employer and when will you be available?
Are you willing to work overnight shifts?
Yes
No
Days Available
Please tell us what days you are available for work (select all that apply):
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Hours Available
Please tell us the hours you prefer to work (select all that apply):
Morning
Afternoon
Evening
Late Night
Overnight
Education and Previous Employment
Have you taken a care aide program?
Yes
No
Care Aide Registry #
LPN #
Expiry Date
School
Date Graduated
Other Health-Related Education
Is your CPR up to date?
Yes
No
Recent Employer
Date Started
Date Finished
Duties
Reason for Leaving
Employer Contact
Employer Phone
May we contact your employer?
Yes
No
Previous Employer
Date Started
Date Finished
Duties
Reason for Leaving
Employer Contact
Employer Phone
Previous Employer
Date Started
Date Finished
Duties
May we contact your employer?
Yes
No
Reason for Leaving
Employer Contact
Employer Phone
May we contact your employer?
Yes
No
Work Experience
Personal Care
Bathing
Bowel care
Catheter bag
Colostomy bag
Manual transfers
Mechanical lifts
Personal hygiene
Peri care
Suppositories/Enemas
Toileting
Medical Care
Quad care
ROM exercises
Suctioning
Compression stockings
Trach care
Blood pressure
Feeding tubes
Glucometers
Medications
Seizure Monitoring
G-Tube
Oxygen Therapy
NG Feeding Tubes
Footcare
Client Diagnosis
ALS clients
Alzheimers care
Brain injury clients
Cerebral Palsy
Dementia care
Diabetic clients
Heart disease
Hip replacement clients
MS clients
Palliative care
Parkinson's clients
Cooking and Cleaning Skills
How would you rate your cooking on a scale of 1 (poor) to 10 (excellent)?
Have you cooked for an elderly client before?
Yes
No
What type of food?
Do you have experience with cooking special diets for clients?
Yes
No
What special diets?
Housekeeping
Changing bed linens
Cleaning cupboards
Cleaning fridge
Cleaning stove
Dusting
Ironing
Laundry
Vacuuming
Washing/drying clothes
Washing floors
How would you rate your housekeeping?
Are you comfortable doing housekeeping for a client?
Yes
No
References
List 3 work related references that we may contact as a reference for you. Excluding family and close friends.
Name
Phone
Position/Company
Name
Phone
Position/Company
Name
Phone
Position/Company
Have you had a criminal record search done within the last year?
Yes
No
If so, please attach copy or mail into the office within two week of employment.
Max. file size: 256 MB.
Have you ever been arrested?
Yes
No
Will you consent to having a criminal record check before being employed with us?
Yes
No
Close Menu
Home Care
Services
Services & Approach
Home Care for Living
Home Care for Health
Pediatric Home Care
Foot Care Nursing
Moments Home Care
Blog
Get to Know Us
About Us
Accredited Home Care
Our People
What Sets Us Apart?
Home Care Resources
Careers
Contact
Vancouver BC
Comox, BC
Prince George, BC
Calgary, AB
Employee Website
Vancouver
604.263.3621
Comox
250.890.7535
Prince George
250.563.3501
Calgary
403.242.2750
Toll-free
1.888.263.5168
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