APPLICATION FORM FOR RESPITE WORKERS

Support Us

Respite (or Casual Relief) Workers are a very important part of the L’Arche Lethbridge community. Respite Workers support the L’Arche Lethbridge homes when the live-in assistants are on their personal time away, on retreat, on holidays, or during those times when there is a temporary shortage of live-in assistants.

Personal Information

Miss, Ms, Mrs, Mr.:

First Name: *

Surname: *

Date of birth :

Email: *

Telephone (including full area or international codes): *

Address: *

City: *

Province or State:

Country: *

Legal Information

All applicants other than Canadian Citizens, Landed Immigrants and Permanent Residents of Canada require a work permit to be employed by L'Arche communities in Canada.

Are you legally entitled to work in Canada:

Yes

Do you have any medical conditions that may prevent you from performing any aspects of the job duties required:

Yes

If yes please explain:

Please note that if your application is accepted you will be required to obtain a medical examination and a criminal record search before you arrive. You will receive more information about this during the course of your application process.

Education, Special Skills & Experience

Highest level of Education completed:

Field of Study:

Number of completed years of education:

Education, special skills description:

Please give a brief description of any additional Education, Special Skills, Work, Volunteer or life Experience that would be relevant to your application.

Do you have a valid driving licence?:

Yes

How would you describe your ability to speak English?:

Don't speak

Basic

Fluent

Excellent

Professional References

Example Employer, Teacher, Supervisor, Clergy

Name:

Email:

Telephone (daytime):

Telephone (evening):

In what capacity?:

How many years has this person known you?:

Professional References

Example Employer, Teacher, Supervisor, Clergy

Name:

Email:

Telephone (daytime):

Telephone (evening):

In what capacity?:

How many years has this person known you?:

Personal References

Example Friend, Colleague

Name:

Email:

Telephone (daytime):

Telephone (evening):

In what capacity?:

How many years has this person known you?:

Finalize Application

Is there anything else you would like us to know with regard to your application?:

I have read and accept the declaration: *

Yes

Declaration
I declare that the information given on this form is to the best of my knowledge true and complete. I agree to L’Arche checking any references from any L’Arche communities where I am presently or may have been involved and understand that these will be confidential between the referee and L’Arche. I also agree to any Criminal Records Bureau or Police checks which may be required as part of L’Arche’s recruitment procedures.

I agree that the information provided in this application form may be processed by L’Arche in relation to my application for this position to assist in the decision making process. I further expressly agree that, should it be necessary to validate any of the information provided therein, L’Arche may release the information for verification purposes. If I am successful in my application, it is agreed that any information provided will be retained by L’Arche in a secure and confidential file, and the contents only used for necessary business purposes, subject to my express consent for disclosure where necessary.

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L'Arche Lethbridge
240 12C Street North
Lethbridge, AB, T1H 2M7

Phone: 403-328-3735
Fax: 403-320-6737
Email:office@larchelethbridge.org