A Friend Indeed: Job Application
The information on this form is collected for the purposes of evaluating your application for employment with our company and should you be offered employment, the application will help us match your skills to appropriate clients. All information collected by A Friend Indeed is protected by the Personal Information Protection and Electronic Documents Act and will be kept confidential. All of the questions below are optional and your consent is implied by submitting answers to the questions.  Thank you.
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Your Name (First and Last) *
Your Address *
City/Town *
Postal Code
 *
Your Best Telephone Number(s) *
Your Email *
Are you ok being around potential allergens? (ie: pets, pollen, etc) *
Languages Spoken? *
How did you hear about A Friend Indeed? *
Do you have a valid Drivers License? *
Anything else you would like to add?
Do you have your own vehicle? *
What year, make and model is your vehicle? Would a senior be able to easily get into and out of it on their own? *
Are you comfortable driving a client in your vehicle? *
What attracted you to apply for the position?
 *
What sets you apart from the other Applicants?
 *
What are your personal values?
 *
Are you willing to work in a smoking environment? *
Availability for work. Please select all of the days and times you are available for work on a consistent basis.
Mondays *
Required
Tuesday *
Required
Wednesday *
Required
Thursday *
Required
Friday *
Required
Saturday *
Required
Sunday *
Required
Is there any additional information you want to share about your availability?
Areas you are willing to work in.
*
Required
Anything else you would like to share about the locations to work in?
Are you working right now? *
What experience do you have with seniors? *
It is not a requirement, but do you have any health related courses or education? *
Work Experience
1. Name of your most recent employer: *
Date started:
MM
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DD
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YYYY
Date completed:
MM
/
DD
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YYYY
Reason for leaving:
Duties:
Contact name and phone number:
May we contact your employer? *
2. Name of your previous employer:
Date started:
MM
/
DD
/
YYYY
Date finished:
MM
/
DD
/
YYYY
Reason for leaving:
Duties:
Contact Name and Phone:
May we contact your employer? *
Please select activities you have experience with and are comfortable performing: *
Required
References: List 3 Work Related References that we may contact. (Excluding family and close friends)
1. Reference (Include: Name, Phone, Position/Company) *
2. Reference (Include: Name, Phone, Position/Company) *
3. Reference (Include: Name, Phone, Position/Company)
Have you had a criminal record search done within the last year? *
Have you ever been arrested? *
Will you consent to having a police record check (with vulnerable sector) before being employed with us? *
I understand that failing to provide accurate information or omission of facts on this form may disqualify me from consideration for employment with A Friend Indeed or subsequent termination if I am employed. Submission of this application form implies your consent to contact you.
Your Name: *
Today's Date: *
MM
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DD
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YYYY
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