General Information









Are you legally entitled to work in Canada?
YesNo
Have you been previously employed by CLL?
YesNo

If you have you been previously employed by CLL, when and where were you employed?


Community Living London supports people with developmental disabilities in their homes and in their community.

1. Are you experienced working in the following environments?
a. Assisting people with personal care (i.e. assisting with personal hygiene, mealtimes and operating lifts)?
YesNo
b. Supporting people who present challenging behaviours?
YesNo

2. Are you willing to work in the following environments?
a. Assisting people with personal care (i.e. assisting with personal hygiene, mealtimes and operating lifts)?
YesNo
b. Supporting people who present challenging behaviours?
YesNo

Availability


Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Days Monday
Available
Tuesday
Available
Wednesday
Available
Thursday
Available
Friday
Available
Saturday
Available
Sunday
Available
Evenings Monday
Available
Tuesday
Available
Wednesday
Available
Thursday
Available
Friday
Available
Saturday
Available
Sunday
Available
Nights Monday
Available
Tuesday
Available
Wednesday
Available
Thursday
Available
Friday
Available
Saturday
Available
Sunday
Available

YesNo

YesNo

Police Check and Training Certifications

Valid driver’s license (G2 class or higher)
YesNo
Vulnerable Sector Police check for Employment issued within the last 12 months
YesNo
Valid first aid and CPR certificate
YesNo
Valid CPI certificate
YesNo

Education




References

Please ensure references are supervisory/ managerial in nature. Volunteer and educational are accepted where work experience is limited.













Resume


Please read carefully

Your authorization on this application form is your consent that as a condition of being considered
for employment, references about past work performance will be obtained from your current and
previous employers.

I certify that the information provided in this application or attachments / resume is true and
complete. I understand that if any information in this application or attachments / resume is found
to be untrue or incomplete, my application may be rejected or I may be dismissed in the event that I
am the successful applicant.

I Agree with the Above Statement