395 Worth Blvd.
Thornhill, Ontario
L4J 8B5
Canada
Phone : (905) 771-5001
Fax : (905) 771-6232
E-mail : 4sterns@infinity.net
You are about to complete an application for employment in Canada. Future employers will compare
your application with others, therefore be sure to write clearly and give as much information about
yourself as possible.
THE FOLLOWING IS A CHECK LIST OF REQUIREMENTS
Please submit the following with your completed application form :
1. A photo of yourself and children. Remember, smiling pictures are the best.
2. Reference letters from previous and present employers (if possible).
3. A letter from you to your prospective employer. Please outline a typical day, your
future interests, your previous work experience.
4. A copy of your current passport, work permit if applicable.
5. A copy of you high school transcript and diploma.
6. A copy of you University transcript and if applicable diploma.
7. A certified cheque made to “Nanny Express Ltd.” in the amount of $200.00 U.S. funds,
for your registration.
I, the undersigned applicant certify and declare that all the information that has been provided to
“Nanny Express Ltd.” is true and that aside from being denied entrance into Canada, I have complete
intention of working for an employer in Canada and will not withdraw my application. I also understand
that once I receive my visa for Canada, I will be coming directly to Canada as soon as I receive my ticket.
I will not be visiting the Philippines prior to my arrival in Canada, unless it is okay with my employer in
Canada.
I am prepared to pay all of the agency fees prior to departure from Hong Kong as well as all my travel expenses.
Applicant’s name :___________________________________________
Applicant’s Signature : _______________________________________
Date : __________________
APPLICATION FOR A LIVE IN CAREGIVER POSITION IN CANADA
NAME : _____________________________________
DATE : _____________________________________
Home Address : __________________________________________________________
___________________________________________________________
Present Address : _________________________________________________________
__________________________________________________________
Telephone Number (Including Area Code) ___________________________
Fax Number (Including Area Code) ________________________________
Indicate position desired (children, elderly, disabled) ____________________
Highest education attainment ________________________________________________
Diploma/Degree obtained __________________________________________________
Additional Education and Training ___________________________________________
_____________________________________________________________________
Date of Birth ___________________ Place of Birth ________________________
Height ___________ Weight ___________
Nationality _______________________ Religion _______________________
What languages do you speak ? ______________________________________________
English Skills :
Spoken Very Good ______ Good _____ Fair _____ None _____
Reading Very Good ______ Good _____ Fair _____ None _____
Written Very Good ______ Good _____ Fair _____ None _____
Marital Status _________________ Number of Children __________ Ages ______
Do you have any allergies ? _____________________________________________
Do you have any physical or mental illnesses ? _________________
If yes, please state the nature of the illness: ____________________________
_______________________________________________________________
How is your general health ? _____________________________________________
What is your passport number ? _________________________________
Expiry Date _______________________
When does your present working visa expire ? _______________________________
Date available for employment ____________________________________________
Can you swim ? ___________ Do you smoke ? ___________
Do you drink alcohol ? ___________
Do you drive ? ___________ Are you willing to learn ? ___________
Hobbies ________________________________________________________________
Will you work with domestic animals (dogs/cats) _______________________________
Can you cook ? _______ What types of food ? __________________________________
Have you taken a first aid course ? _______________________________
Are you willing to work for a single parent ? _______________________
How many children are you willing to take care of ? _________________
Do you have experience with the elderly ? _________________________
Can you administer medication ? ________________________________
What activities will you do with children ? ___________________________________
______________________________________________________________________
What outdoor sports will you do with children ? _______________________________
______________________________________________________________________
What kind of food would you feed children ? ___________________________________
_____________________________________________________________________
Please indicate beside each of the following which duties you can perform.
Please indicate your skill level with the following tasks using the following words :
Satisfactory / Good / Excellent
Housekeeping _____________________ Care of babies (infants) __________________
Cooking __________________________ Changing diapers ______________________
Laundry __________________________
Preparation of Formula (baby bottle) _________________________
Ironing ___________________________ Feeding baby _________________________
Elderly Care _______________________ Grocery shopping _____________________
Caring for disabled __________________
Would you be willing to work a 6 day work week ? _______________
Which age group do you prefer to care for ? _____________________
Please explain what makes you a good candidate for a caregiver
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Please attach a letter of reference to this application.
You must have a college level education (72 units).
You also require a minimum of 6 months of full time training in a related field to the position you are seeking.
I, the undersigned applicant hereby certify and declare that all of the above information is true and that aside from being denied entrance into Canada, I have complete intention of working for an employer in Canada and will not withdraw my application.
Applicant’s Signature : _____________________________________
Date : _______________________