Become a Care Provider

Independent Care Provider

Independent care providers working with Cornerstone Community Care are compassionate, reliable people, dedicated to the support and well being of seniors and others with special needs.

Our services are non-medical and no prior experience is required, as personality and attitude are also considered as well as skill and experience. As a self-employed care provider, you have the flexibility of working the hours suitable to you.

If you are a motivated individual and believe you have the qualities required, complete the form below and begin the process that can lead to a challenging and rewarding career, making a difference in the lives of the people you serve.

Applicant Information
Name:
Address:
City:
Province:
Postal Code:
Telephone:
Email:
1. Work Experience (Please list most recent first)
Employer:
Position:
Supervisor:
Address:
Telephone:
Email:
Date of Employment:
Responsibilities:
Reason For Leaving:
2. Work Experience
Employer:
Position:
Supervisor:
Address:
Telephone:
Email:
Date of Employment:
Responsibilities:
Reason For Leaving:
3. Work Experience
Employer:
Position:
Supervisor:
Address:
Telephone:
Email:
Date of Employment:
Responsibilities:
Reason For Leaving:
Education/Training (List secondary and post-secondary education including course of study, and degree or diploma received)
Education/Training:
List of other relevant training:
Other Activities (List volunteer work, leadership positions, or other activities that you feel may be relevant)
Other Activities:
1. Personal Reference
Name:
Telephone:
Occupation:
2. Personal Reference
Name:
Telephone:
Occupation:
3. Personal Reference
Name:
Telephone:
Occupation:
Other information:
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