Click the LinkedIn link to use your LinkedIn profile to pre-fill this application form.
Click the Upload Resume to use your resume to pre-fill this application form.
Email Registration
Your email address will be used as your login name allowing you to return to our website update your profile. If you do not have an email address, you can obtain a free account at Yahoo or Hotmail . Please make sure that the syntax of your email address is in the following form: username@ispname.com
Email: *
Please create your password
Passwords must be at least six(6) characters
Password: *
Re-type new password: *
Questions
Online Questions:
3. Please indicate which life saving certificates you hold:Online Question 3
First Aid
CPR
ACLS
BCLS
4. Please provide your CNO Registration Number * Online Question 4
5. Are you comfortable driving in evening or winter weather conditions? * Online Question 5
Yes
No
Personal Information (Please enter Full Legal Name as it appears on your Birth Certificate or Passport)
First name: *
Middle:
Last name: *
Primary Phone #: *
Secondary Phone #:
Street address: *
City: *
Province: *
Please select
CA-AB
CA-BC
CA-MB
CA-NB
CA-NF
CA-NS
CA-ON
CA-PE
CA-QC
CA-SK
CA-NT
CA-YT
ON
ZIP/Postal code: *
Country: *
Please select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia
Botswana
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Canada1
Cayman Islands
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Korea, North
Korea, South
Kuwait
Kyrgyzstan
Lao Democratic Republic
Latvia
Lebanon
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Malta
Mexico
Micronesia
Moldova
Monaco
Mongolia
Morocco
Mozambique
Myanmar
Namibia
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Saint Lucia
Saint Vincent Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Sierra Leone
Singapore
Slovakia
Slovenia
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vatican
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
How did you hear about us?
Source: *
--None--
Appcast
Billboard
Campus Pipeline
Career College
Careerbeacon
Careers Website
Caring Support
Charity Village
Craigslist
Employee Referral
Employment Agency
Facebook
Flyer
Goodwill
Google-Jobs
HFO - Health Force Ontario
Hiring event - Indeed
Hospital News
Indeed.com
Instagram
Internal
Job Bank
Job Fair
Jobillico
Kijiji
Lead Generation team
Leadership Edge
LHH Knightsbridge
LinkedIn
Lunch & Learn
Neuvoo
Newspaper Ad
Ontario Society of Occupational therapist (OSOT)
OPSWA
Passive Candidate Complier - Skill Survey
Peoplemenders
Radio Ad
RN Careers (RNAO)
RPNAO
SE Landing Page
SE Rewards
Simply Hired
Student Placement
Walk-In
Workopolis
YMCA
YMCA
Other (Specify Source):
Referred By:
Additional Information
Date available to work?: *
Please select
As soon as possible
Within 1 week of hire
Within 2 weeks of hire
Within 3 weeks of hire
Within 4 weeks of hire
Desired Rate (Hourly$):
Employment Desired: *
Please select
Full-time
Part-time
Casual
Days
Evenings
Nights
Weekends
In the space provided below, please provide hours and days available for work?
Hours/Days Available:
Work Authorization: *
Please select
I am authorized to work in this country for any employer
I am authorized to work in this country for my present employer only
I require sponsorship to work in this country
My status to work in this country is unknown
(Upon hire, you must provide proof of your identity, Social Insurance Number, and valid work permit if applicable)
Have you ever worked for Saint Elizabeth?
Previously Employed?: *
Please select
Yes
No
If yes-date/role/location:
Are you related to anyone who works for Saint Elizabeth?
Relatives?: *
Please select
Yes
No
If yes, in the space provided below please indicate your relationship, their role, date of employment and location where they are currently working.
Relative(s) Information:
Have you ever been convicted of an indictable offense for which a pardon has not been granted?
Yes or No: *
Please select
Yes
No
Education:
Certificates/Licenses:
Employment History - (PLEASE PROVIDE ACCURATE, COMPLETE EMPLOYMENT RECORD. START WITH MOST RECENT EMPLOYER FIRST):
Resume Attachment
Your resume can be uploaded in any of the following formats: DOC, DOCX, RTF, PDF, TXT, HTML.
Add Resume & Attachments
Cover Letter
You can use the text area for a cover letter and any supplementary information you would like to provide about your career goals, availability, best times to contact you, etc.
Cover Letter:
Disclaimer and Signature
I hereby certify that the information herein provided in this Employment Application is true and complete to the best of my knowledge. I understand that false statements or omissions may disqualify me from employment, or if employed, cause my dismissal without notice and/or severance. It is understood and agreed that my employment is subject to satisfactory references and criminal record checks. Saint Elizabeth is authorized to obtain employment references and make inquiries concerning the information given herein and I agree to release any person or organization from liability for the consequences of answers to such enquiries. I hereby release Saint Elizabeth from any liability associated with the provision of references related to my employment at Saint Elizabeth, during my employment or thereafter.
Personal information related to the recruitment and hiring process is collected under the authority outlined in the Personal Information Protection and Electronic Documents Act (PIPEDA, Canada 2004). This information will be used to determine eligibility for employment with Saint Elizabeth. The use and disclosure of personal information by Saint Elizabeth is in accordance with PIPEDA. If you have any questions about the collection, use or disclosure of personal information, please e-mail our Privacy Officer at privacyofficer@saintelizabeth.com
Signature: *
Date: Format: M/D/YY *