Position(s) Applied for:*
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Posting Number:
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Type of Employment wanted:
Full Time
Part Time
Casual |
Location of Employment Desired:
All Sites
Markdale
Wiarton
Lion's Head
Meaford
Southampton
Owen Sound |
Available for shift work if Required:*
Yes
No |
Date Available:*
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Telephone:*
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Last Name:*
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First Name:*
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Address:*
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Email Address:*
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Are you eligible to work in Canada?*
Yes
No |
Were you previously employed by us?*
Yes
No |
Is there anything that would prevent you from performing the essential duties of the job(s) for which you have applied? *
Yes
No |
Have you ever been convicted of a criminal offense for which you have not received a pardon?*
Yes
No |
How did you hear about Grey Bruce Health Services?*
GBHS Web site
Other Web site
Newspaper
Magazine
Job Fair
Another Employee(Referral)
(employee name)
Word of Mouth
Facebook
Poster/Bulletin
Other
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Please attach your resume in a word(.doc) or PDF(.pdf) format:
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OR
Copy and paste your resume here.
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Nursing Applicants:
Clinical Areas Preferred
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Ontario Certificate of
Competence Number
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Date of
Last Renewal
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Has your license ever been revoked/reduced/restricted or suspended?
Yes
No |
Level of C.P.R. Certification
Heart Saver
B.C.L.S.
A.C.L.S.
P.A.L.S. |
Date of Expiry of C.P.R. Certification
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Professional Associations - Include Name
of Asssociation, Current and Pending Registration, and Registration
Number
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Other Work Related Skills - Describe any
skills, training or experience (including volunteer work)
that may relate to the position applied for
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Acknowledgment
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. |