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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
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| 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
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| 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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