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CSCL's ShareVision Home Page > Surveys  > New Survey

New Survey: Application - External


 
Header - General Information
Header Section - #95B3D7
Date Of Application *
Select a date from the calendar.
First Name *
Last Name *
Email Address *
Primary Phone *
Cell Phone
Work Phone
Home Address *
Please include city and postal code.
Mailing Address (If Different From Home Address)
Please include city and postal code.
Have You Applied At CSCL Before? *
Header - Employment Prerequisites
Header Section - #95B3D7
Do You Have A Valid BC Driver's License? *
   
If Yes, what Class?
Class 7 Licenses
Select a date from the calendar.
If you currently hold a Class 7 license, what date are you eligible to obtain a Class 5?
If required, do you have a reliable vehicle that you would be willing to use for work? *
Header - Education
Header Section - #95B3D7
Education and Training *
Please list in chronological order, beginning with the most recent. Include name & location of school, Dates attended, certificate/diploma/degree completed & date received, and field of emphasis.
Do You Have A Valid First Aid/CPR Certificate? *
A valid First Aid/CPR Certificate is required within the probationary period if hired. If you are hired and do not have a valid First Aid/CPR certificate at the date of hire, you will be required to pay for your certification.
Do You Have A "Caring About Food Safety" Certificate? *
A Caring About Food Safety certificate is a mandatory requirement (even if you already have FoodSafe) and can be completed at http://www.health.gov.bc.ca/protect/food-safety-module/files/home.htm please submit a signed and dated copy.
Header - How did you hear about us
Header Section - #95B3D7
Where Have You Seen Us Advertised? *
   
You can select multiple options.
Did You Hear About Employment Opportunities From A CSCL Employee? *
Please let us know what employee recommended CSCL to you as a prospective employer.
If so, what is their name?
Header - Conditions of Employment & General Info
Header Section - #95B3D7
Are you legally entitled to work in Canada? *
Criminal Record *
Have you ever been charged with or convicted of any criminal offences for which you have not received a pardon that remains in effect?
Are you applying to work with: *
For what type of position(s) are you applying? *
Posting # (If Applicable)
Previous Employee Section:
Check this box if you have ever been employed by CSCL
Previous Employee Section: Program(s)
Please provide the dates and the program(s) you worked in.
Employee Relation Section:
Do you have any relatives or anyone in your household currently employed at CSCL?
Employee Relation Section: Name
Please provide their name and relation to you.
Relations in Service Section:
Do you have any relatives or anyone in your household currently receiving services from CSCL?
Relations in Service Section: Name
Please provide person's name and CSCL Program/Service:
Physical Limitations *
Please list and explain any limitations to lifting, bending, kneeling, pulling or pushing.
Header - Availability
Header Section - #95B3D7
Date you are available to begin work *
Select a date from the calendar.
Employees are typically hired on a casual/on-call basis; once hired, employees may apply for internal postings. Minimum availability requirements: three (3) shifts per week
How many hours per week are you seeking? *
Are you willing to work night shifts (11pm-7am)? *
If No: Please Explain
Current Employment Section:
Are you currently employed? Check this box if yes.
Current Employment Section: Where? *
Header - Employment History
Header Section - #95B3D7
Most Recent Employer: Name and Location *
Most Recent Employer: Dates of Employment *
(MMYY) - (MMYY)
Most Recent Employer: Job Title & Duties/Responsibilities *
Most Recent Employer: Reason for Leaving *
Most Recent Employer: Permission to Contact Following Interview *
Permission to contact supervisor for a reference?
Most Recent Employer: Permission to Contact - No *
If no, please explain
Other Employer 1: Name & Location of Employer
Other Employer 1: Dates of Employment
(MMYY) - (MMYY)
Other Employer 1: Job Title & Duties/Responsibilities
Other Employer 1: Reason for Leaving
Other Employer 1: Permission to Contact Following Interview?
Permission to contact supervisor for a reference?
Other Employer 1: Permission to contact - No
If No, please explain
Other Employer 2: Name & Location
Name and location of employer
Other Employer 2: Dates of Employment
(MMYY) - (MMYY)
Other Employer 2: Job Title & Duties/Responsibilities
Other Employer 2: Reason for Leaving
Other Employer 2: Permission to Contact Following Interview?
Permission to contact supervisor for a reference?
Other Employer 2: Permission to Contact - No
If No, please explain.
Header - Additional Information
Header Section - #95B3D7
Why are you applying to the Chilliwack Society for Community Living *
Signature of Applicant
By checking this box, I certify that all information in this application is true and complete. I understand that if any information is found to be false, such information may be cause for discharge or refusal of employment. I hereby authorize the Chilliwack Society for Community Living to discuss this application and my abilities, skills, qualifications and experience in order to determine my suitability for possible employment. Thank You, please scroll down and click "OK" to send your application.
Header - Admin Section Only
Header Section - #ff0000
Admin Only: Year
Admin Only: Type of Application
Admin Only: Department
   
Admin Only: Comments
Please record your first impression of the applicant, i.e. dress, tone, politeness, neatness of written application
Admin Only: Interview
Admin Only: Date Interviewed
Select a date from the calendar.
Admin Only: Confirmation Email Sent
Admin Only: Pre-Interview Screening
View *
This column contains information used by the system. Please do not modify or delete.