Type of Employment wanted:

    Available for shift work if Required:










    Are you eligible to work in Canada?*

    Were you previously employed by us?*

    Is there anything that would prevent you from performing the essential duties of the job(s) for which you have applied? *

    Have you ever been convicted of a criminal offense for which you have not received a pardon? *

    How did you hear about Grey Bruce Health Services?*



    The following questions are for Nursing Applicants only:





    Has your license ever been revoked/reduced/restricted or suspended?*

    Level of C.P.R. Certification






    By submitting this information, I hereby certify that all the statements made by me on this application form and/or resumé are true and complete and I understand that a misrepresentation or omission of the facts will constitute full and sufficient grounds for rejection of this application or for dismissal of employment. I understand it is the policy of Grey Bruce Health Services (GBHS) to conduct a Criminal Background Check which may preclude me from obtaining employment. In the event that GBHS further pursues my candidacy, I understand that GBHS will notify me of its intent to investigate my previous employment, educational data, references and background checks and permission is hereby given. I also understand that if employment is offered pending satisfactory completion of the background check or reference checks and if either is not satisfactory to GBHS, the employment offer will be rescinded. I understand that should I be successful in obtaining employment with GBHS, the cost of the criminal background check will be deducted from my pay, and I hereby grant permission to do so. I also understand that employment is subject to the completion of a health review.

    Acknowledgment of statement above:

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