Firstname *
Lastname *
Date of birth
Street and house number
City
Province/State
Country
Your citizenship
Your country of residence
Work permit/visitor visa
Do you have a passport?
Your telephone number
Mobile phone number
E-Mail address *
Skype ID
Height
Weight
Colour of eyes
Marital status
Your children
Full name (last name first)
Date of birth
City of birth
Country of birth
Gender
Your spouse
First and last name
Date of birth
City of birth
Country of birth
Current Address
Occupation
Your brothers and sisters
First and Last name
Date of birth
City of birth
Country of birth
Family status
Current address
Occupation
Your parents
First and Last name
Date of birth
City of birth
Country of birth
Family status
Current address
Occupation
When is the best time to phone you? What type of work do you prefer? Please make a X for the right answer
Day
From
To
Children
Elderly people
Sick people
Disabled children
Disabled adults
Does no matter
Your education (start whit the last studies)
From (month/year)
To (month/year)
Name of school
Diploma achieved
Your professional experience (list all employments since completing your education)
From
To
Name of employer
Employers address
Your position
Tell me something about your past jobs that relate to the position of a live-in caregiver. Please be as detailed as you can. This will be a part of you profile that employers will see.
Do you have a driver license?
Date issued
Any accidents or tickets?
What is y our religion?
Do you have any restrict ions related to your religion, like days when you cannot work, food that you cannot eat, etc.?
Can you cook?
Do you like to cook?
What kind of food can you prepare?
Are you willing to learn how to cook?
Are you vegetarian?
Can you play musical instrument? Which?
Can you swim?
What other sports do you like?
What languages do you speak fluently?
What languages do you speak partially?
Do you have experience whit housekeeping?
Is there anything that you are not willing to do in the household?
Do you like dogs and cats?
Are you willing to care for pets?
Are you allergic to any food or anything that may prove to be life threatening? Please describe the details.
What do you believe is your best feature making you a good caregiver?
What is your favourite hobby or activity - how do you like spend your time off work?
Why do you want to come to Canada? Feel free to describe your dreams, your goals - be as honest as you can.
Address where you lived since your 18th birthday (permanent address) - i.e. 08/1995 - 10/1999
From Month/Year
To Month/Year
Address
Do you have any relatives or friends in Canada?
Name
Relationship
Address
Do you or your close family members (spuse and children) have any medical condition that may be a reason for medical inadmissibility? Please be honest - you don´t want to waste your time and money!!! Write "Not applicable" in the first line if your family members are healthy.
Name
Relationship
Diagnose
Details about membership in professional, political, sport or other organizations
From
To
Name of organization
Type of organization
Your position
This is the most important part of your assessment sheet. Please write a letter to your future employer. Tell them who you are, why you want to be a caregiver, what makes you good, why shoud they select you. Write as much as you want. Be honest and open - this is your only chance to make a good first impression.
You may upload one picture with your assessment sheet. Only jpg and gif formats are acceptable.
Description:
I declare that the above information is true and that I have not concealed or omitted any information relevant to the above questions:
Signature: Spam prevention question: