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Complete
the following questionnaire for
free assessment For Live-in Caregiver
Application. Please be sure to
provide us with your valid email
id. |
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Section
A ( For the Foreign Worker ) |
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Full Name: |
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| Sex: |
Male
Female |
| Date
of Birth: |
Day Month Year
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| Place
Of Birth: |
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| Citizenship: |
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| Current
Mailing Address: |
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| E-mail:
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| Tel
/ Fax: |
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Marital
Status :
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(Never Married, Engaged, Married,
Widowed, Separated, Divorced/Annulled
Marriage) |
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Do you or
your spouse have relatives in
Canada (Spouse, Fiancé(e),
Partner, Parents, Grandparents,
Grandchildren, Brother, Sister,
Nephew, Niece, Uncle and Aunt)?
If yes, please give details:
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Please provide details of your
post secondary education (academic,
professional or technical) from
matric/secondary school onwards
with dates, names and addresses
of Institutions attended, courses
taken and degree/diploma/certificate
received. Indicate all full time
and part time courses. Please
do not use abbreviations. |
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Please provide detailed employment
record with dates, names & addresses
of employers and job designations
held: |
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| Can
you provide detailed experience
letters for each employment?
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Areas of Training/Expertise:
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| Any
full-time training? If yes, Please
specify: |
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| Please
tick which every is applicable |
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A. Successful
completion of a course of study
that is equivalent of completing
a Canadian secondary education.
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B. Successful
completion of Six months full-time
formal training in a field or
occupation related to the employment
for which the employment authorization
is sought (this training may be
completed in a classroom setting
as part of the course of study
referred to in paragraph A, OR
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C. Completion
of one year of related full-time
paid employment, including at
least six months of continuous
employment with one employer,
within the three years immediately
prior to the day on which the
person submits an application
for an employment authorization.
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D. The ability
to read, speak and understand
either English or French language
at a level sufficient to communicate
effectively in an unsupervised
situation.
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E. No Medical
Conditions.
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F. Detailed Reference
Letters.
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G. Area of
experience/training |
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Early childhood
care/education
Old age care
Mentally/Physically disabled
Terminal care
Recovery from illness/surgery
Domestic help (cleaning, cooking
etc)
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For
Employer (In Canada) |
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Full Name: |
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| Sex: |
Male
Female |
| Date
of Birth: |
Day Month Year
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| Place
Of Birth: |
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| Citizenship: |
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| Current
Mailing Address: |
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| E-mail:
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| Tel
/ Fax: |
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Are your self employed ----Yes/NO
(If yes please provide details
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| Your
yearly Income |
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Income of your spouse |
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| Other
Income |
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Total Family
Income |
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Employment
Detail |
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Please provide detailed employment
record with dates, names & addresses
of employers and job designations
held: |
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Please provide detailed employment
record of your Spouse with dates,
names & addresses of employers
and job designations held: |
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| I
hereby, certify that all the information
provided above is true, accurate
and complete and I have signed. |
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