Hiring Application Form

Thank you for your interest in joining Prime Holistic Care Corp. Please complete this form accurately. All information will be kept confidential.

Full Name

Date of Birth

Phone Number

Email Address

Social Insurance Number (SIN)

Current Address

City

Province

Postal Code

Position

Preferred Employment Type

Preferred Shift(s)

Available Start Date

Are you legally eligible to work in Canada? Yes No

Professional Designation

Licensing/Registration Number

Province of Registration

Expiry Date

Years of Healthcare Experience

Areas of Experience

Please list your general availability (days/times)

Reference 1

Reference 2

Please share why you are interested in working with Prime Holistic Care Corp.

Resume / CV

Cover Letter

I certify that the information provided is true and complete to the best of my knowledge.