1 – Applying Position
Caring for People with High Medical Needs Pathway
A pathway to permanent residence for caregivers who have provided care for the elderly or those with disabilities or chronic disease in a health facility (Homecare/Nursing Home) or in a home.PLEASE CHOOSE ONE:
Live-out (Healthcare facility) _____
Live-in (for family)____
PLEASE CHOOSE THAT MAY QUALIFY:
Registered Nurse (regulated): ____
License Practical Nurse (regulated)____
Nurse aides (non-regulated)____
Orderlies and patient service associates (non-regulated)___ /
Caring for Children Pathway
A pathway to permanent residence for caregivers who have provided child care in a home.Caregiver Live-out only (family)___
2 - Personal Information
Name:
Date of Birth :
Sex (Male/Female):
Present Marital Status:
Current Mailing Address including Postal Code:
Contact Number:
Email Address:
Relatives in Canada: (Please mention Relation):
Valid Driver License: (Yes or NO)
Applicants, who have a current valid, clean driver’s license for a minimum of 2 years, will be accepted with a minimum 1 year experience & positive references. Applicants who drive are always in demand.
3 – ELIGIBILITY
Equivalency of successful completion Canadian Grade 12 PLUS one year full time university / college in Canada.(Applicants educated in the Philippines will need successful completion of 4 years of University / College studies).Applicants who have completed the Bachelor of Science in Nursing (4 years college diploma) will be accepted withno paid employment required; the same is true for persons with College diplomas related to Special Needs Care.
For the applicants who have 4 years course but not in healthcare/childcare related, at least 2 years full time paid employment related to the caregiving “Pathway” chosen, completed within three years immediately prior to the day on which the caregiver submits their application for a work permit.
Education
Duration / Academic & Professional Qualification / Marks Obtained / Name of School/University with country
From / To
Work Experience
Total number of years of experience with complete history of past 10 years:
Duration / Name of the Company / Designation and Job Profile
From / To
MM / YY / MM / YY
Ability in Language
ENGLISH: (High/Moderate/Basic/None) Mention IELTS results
SPEAKING:
LISTENING:
READING:
WRITING:
FRENCH: (High/Moderate/Basic/None)
SPEAKING:
LISTENING:
READING:
WRITING:
Protection of personal information
This form is for the company’s use only. In order to succeed in obtaining a permanent residence to Canada, it is very important to answer all questions fully and truthfully. We will review each application, and will respond accordingly.
The personal information appearing on this form, and in any documents that must be appended to it, is required for processing your applicationfor Immigration to Canada, Act respecting immigration to Canada, the Regulation respecting the selection of foreignnationals, the Regulation respecting the immigration consultants and their administrative regulations.
Your personal information is confidential and may not be disclosed without your consent unless explicitly authorized by you.
DECLARATION
I declare that the information contained in this application and appended documents, if any, is complete and accurate and I will notify the representative of any change in answers given on this form before the submission of application to Immigration Department (CIC), CANADA.
I acknowledge that I have read the notice on the protection of personal information in the section above.
I further acknowledge that by saving this document and sending the same to my legal representative electronically, constitute my consent to use the information and no physical signature is required.
I also agree that Universal Immigration will be making an initial assessment on the basis of the limited information provided on this form.