Employment Application - Oakville & Burlington
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Thank you for your application to Nurse Next Door! Please complete all fields to be considered as a candidate. We are looking for candidates who respect others; are able to WOW customers; always seek a better way; and are sincerely passionate about making a difference in people's lives. This application is for ONTARIO residents only. .
First Name:
Last Name:
Home Phone:
Email Address:
emailaddress@xyz.com
City:

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How should we contact you?
Home Phone
Email
Other 
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Employment Type
Registered Nurse (in Ontario)
Registered Practical Nurse (in Ontario)
Personal Support Worker (in Canada)
Non-certified Companion or Support Worker
Other 
Availability:
 
Monday
Mornings [0700-1200]
Afternoons [1200-1800]
Evenings [1800-2200]
Overnights [2200-0700]
Other 
  • Comment:

  • 500 character(s) left.
Tuesday
Mornings [0700-1200]
Afternoons [1200-1800]
Evenings [1800-2200]
Overnights [2200-0700]
Other 
  • Comment:

  • 500 character(s) left.
Wednesday
Mornings [0700-1200]
Afternoons [1200-1800]
Evenings [1800-2200]
Overnights [2200-0700]
Other 
  • Comment:

  • 500 character(s) left.
Thursday
Mornings [0700-1200]
Afternoons [1200-1800]
Evenings [1800-2200]
Overnights [2200-0700]
Other 
  • Comment:

  • 500 character(s) left.
Friday
Mornings [0700-1200]
Afternoons [1200-1800]
Evenings [1800-2200]
Overnights [2200-0700]
Other 
  • Comment:

  • 500 character(s) left.
Saturday
Mornings [0700-1200]
Afternoons [1200-1800]
Evenings [1800-2200]
Overnights [2200-0700]
Other 
  • Comment:

  • 500 character(s) left.
Sunday
Mornings [0700-1200]
Afternoons [1200-1800]
Evenings [1800-2200]
Overnights [2200-0700]
Other 
  • Comment:

  • 500 character(s) left.
Are you interested in Live In shifts?: A Live In caregiver is a PSW who will stay at one client's house for 24 hours at a time. The caregiver chooses if they want to do only one shift at a time or stay for two or three in a row. The benefits for the staff are that they don't have to drive back and forth from one day to the next and that they can maximize their hours per day to allow more time off the remainder of the week. The shift will start at 0800 and continue until 0800 the following day. Duties would include personal care, socialization, meal preparation, light housekeeping etc. The caregiver is entitled to a 4 hour break during the day when they can leave the house. The client can choose to remain by themselves at that time, have a neighbour or friend attend or pay for another caregiver during the break time. Many of the caregivers choose to "cover their own break" and remain at the house. In that case, an additional 4 hours of hourly rate pay will be added to the 24 hour flat rate shift pay. No care is given during the night and the caregiver must receive at least 6 hours of uninterrupted sleep. The client must provide suitable sleeping accommodations. If there is an unexpected need for care in the night the caregiver will be paid an additional hourly rate for time spent providing care. If the need for this becomes routine, the client will be advised they will have to increase care to 24 hour care.
Yes
No
Languages spoken:
English
French
Other 
Required
Do you have a valid Ontario driver's license?
Yes
No
  • Comment:

  • 500 character(s) left.
Required
Do you have access to a vehicle?
Yes
No
  • Comment:

  • 500 character(s) left.
Required
Have you had a TB test within the past 2 years?
Yes
No
  • Comment:

  • 500 character(s) left.
Required
Have you had a Criminal Background Check completed within the past 12 months?
Yes
No
  • Comment:

  • 500 character(s) left.
Describe briefly what makes YOU special or any unique talent YOU bring to healthcare.
 

  • 350 character(s) left.
What do you believe are the top 2 characteristics of the very best caregivers (choose only 2 words)?
 

  • 50 character(s) left.
Describe why YOU are the very best applicant for Nurse Next Door, based on what you know of the company.
 

  • 500 character(s) left.
How did you hear about Nurse Next Door (choose one)?
Web search
Newspaper article
Newspaper ad
Saw the Pink cars
Friend
Craigslist
Kijiji
Other 
Thank you for your application to Nurse Next Door! We'll be in touch shortly with the next steps.