Nannies

 

Caregiver Application Form

- Please fill in all fields

You may also download your application form in pdf or MS doc format, print, fill-out and mail it to us.

> Application Form Download (pdf)

> Application Form Download (doc)

Personal Information:


Name (first, middle, last)
Password (At least 5 characters long)
Password Confirm
Address
Street
Province
Country
Postal Code
How would you like to be contacted?
Cell Phone
Work Phone
Email Address
Country of Birth
Date of Birth
Languages
What is your religion?
Marital Status
Number of Children
Age of Children
What Countries Have You Been To?
Do You Drive?
Do You Have an International License?
Are You Willing to Learn?
How many children are you willing to look after?
Will you work in a rural setting?
Do you like pets?
Do you have allergies?
Are you on a special diet?
Do you smoke?
Do you swim?
What days do you want to have off?
What sports do you play?
What is your hobby?
Describe your personality
How do your friends describe you?
How does your employer evaluate your work?


Work Experience:



Childcare:

In which country did you work as a live-in Nanny?
How long did you work in this country?
Have you worked with special needs children?
How long have you worked with special needs children?
What were the ages of the children you have cared for?

Elderly Care:

Have you had experience working for elderly client?
If so, how long?
Elderly illness and condition:
Describe your experience
How would you describe your experience with regards to their health, illness, age and condition in relation to your duties and responsibilities?
Are you willig to...
What types of food are you able to cook?


Educational Background


Enter your college and Year Graduated
Enter your University and the year graduated
Courses completed and year graduated
Care giver course and year graduated
First Aid / CPR Training and year graduated
Have you been involved in any organization?
Enter organization and the year you graduated.
Have you done any volunteer work?
Enter year and type of service


Employment Record


Employer Last Name
Employer First Name
Employer Middle Name
Employer Address
Employer City
Employer Province
Employer Country
Employer Phone
Employer Email
Start Date
Finish Date
Position
Number of Children
Ages
Elderly Client
Elderly Clients Age
Elderly Condition
If you cared for an elderly client describe their condition
Duties and Responsibilities
Reason for Leaving
city
Please explain why an employer would like to hire you

In addition to this online form, we request that you mail us the following:

a) reference letter;
b) photos with the children/elderly client;
c) copy of your diplomas or certificates;
d) Current Police Record Clearance Check;
e) Medical Record (optional).

Address to
Ephraim Global
27 Alderney Ave,
Hamilton Ontario L9A 2A6