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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
Home Address *
Please include city and postal code.
Have You Applied At CSCL Before? *
Posting # (If Applicable)
If you are applying for a specific job posting; what is the job posting number you are applying for?
Header - How did you hear about us
Header Section - #95B3D7
Where Have You Seen Us Advertised? *
You can select multiple options.
Header - Conditions of Employment & General Info
Header Section - #95B3D7
Which population do you want to work with? *
(Check all that apply)
What services would you prefer to work at? *
(Check all that apply)
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
What type of position are you looking for? *
Header - Employment Prerequisites
Header Section - #95B3D7
Do You Have A Valid BC Driver's License? *
NOTE: Applicants with a valid Class 5 or Class 4 drivers license will be prioritized.
Do you have access to a reliable vehicle? *
Note: Some positions at CSCL require staff to use their own personal vehicle for work purposes. However, if you do not have access to a vehicle - that is OK; it may just limit the programs you can work at. Note: Majority of CSCL's programs have their own vehicles and do not require staff to use their own personal vehicles.
Can you provide proof of Covid Vaccination
In order to abide by the Provincial Health Orders and the need for a proof of COVID vaccination to access certain community venues AND given the nature of the positions at CSCL that requires you to support Individuals with diverse abilities to access their community - employees must have their own proof of vaccination to do this. NOTE: If you select 'No' your employment application will be placed on hold until such time that the orders from the PHO are changed. NOTE: If you select "Yes" your employment application will be reviewed and considered for employment and at an upcoming step of the hiring process - you will be asked to provide visual confirmation to CSCL to verify and confirm your proof of vaccination status.
Header - Education
Header Section - #95B3D7
Education and Training *
Tell us about your education and past work experiences that will make you a great asset to CSCL.
Header - Employment History
Header Section - #95B3D7
Current Employment Section:
Are you currently employed? Check this box if yes.
Current Employment Section: Where Do You Work?
Current Employment Section: How Long Have You Worked There?
Do you have a current resume? *
NOTE: CSCL will contact you to provide your resume via email if you are deemed qualified.
Header - Additional Information
Header Section - #95B3D7
Why do you want to work at the Chilliwack Society for Community Living (CSCL)? *
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 - #ffc000
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.
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?
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?
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?
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 please submit a signed and dated copy.
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:
How many hours per week are you seeking?
If No: Please Explain
Most Recent Employer: Name and Location
Most Recent Employer: Dates of Employment
Most Recent Employer: Job Title & Duties/Responsibilities
Most Recent Employer: Reason for Leaving
Most Recent Employer: Permission to Contact - No
If no, please explain