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Senior Care Connect Caregiver Sign Up

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First name *
Last name *
Email *
Phone number 
What is your availability to work (i.e weekends, Monday to Friday, evenings only, certain days of the week etc) *
What areas of the city would you work in (i.e Scarborough, Downtown, North Yrk, Markham, Pickering etc) *
Submit a photo of your self (Optional)
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What is your professional designation (i.e PSW, RPN, nursing student, PSW student, etc) *
Credential Document
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Other Document
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Do you have a clear police screen/check done within the last 12 months? *
What type of help/assistance are you able/trained to provide to clients? *
What langue/s do you speak? *
How many years of experience do you have providing care to elderly/seniors? *
How much do you charge per hour? (i.e $18/hr, $21/hr, etc) *
Families often want to know about caregiver's personality to help match the right person with their loved one. Please share some of your interests or hobbies? (Example: Travelling, Reading, Playing soccer, spending time with family, going to the movies, etc) *
What made you decide on a career in caregiving/Why did you want to become a caregiver? *
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