L'Arche Hamilton

1. Personal information

Miss, Ms., Mrs., Mr.

Name

First/Given Name(s) *

Surname/Family Name *

Date of birth (dd/mm/yyyy)

Email *

Telephone. Daytime. Including full local or international code. *

Complete mailing adress

Street address *

Apartment

City *

Province / State

Country

Canada

Postal code / Zipcode *

2. Legal Information

Are you a Canadian Citizen, Landed Immigrant or Permanent Residents of Canada? *

No Yes

3. Relevant information

How did you hear about L'Arche?

A friend or family member
An affiliate of L’Arche
Journal or magazine
World Wide Web
Other (please specify)

Have you applied to more than one L'Arche Community? (Please apply only to one community at a time and not several concurrently).

No Yes

Why do you wish to come to a L’Arche community?

Have you ever been employed by, volunteered in, or visited a L'Arche community before?

No Yes

If yes, please name the community here:

Year(s) in which you lived in this community:

How long would you hope to be in L’Arche? (We give priority to those who can commit for at least one year) *

1 year
2 years
3 years and more
6 months

When would you be available to start? (Month/Year)

4. Education, Special Skills & Experience

Highest Level of Education completed:

Field of Study:

Number of completed years of education

Please give a brief description of any additional Education, Special Skills, Work, Volunteer or life Experience that would be relevant to your application as a live-in house assistant:

Do you have a valid driver’s license?

No Yes

How would you describe your ability to speak English?

Don't speak
Basic
Fluent
Excellent

How would you describe your ability to speak French?

Don't speak
Basic
Fluent
Excellent

5. References

Please provide the names, e-mail addresses, addresses and telephone numbers of 3 references whom we may contact. One of these references has to have known you since at least 3 years. These references should not be members of your family.

1) Professional reference (ex. Employer, Supervisor, etc.)

Name

Telephone (daytime)

Telephone (evening)

In what capacity?

How many years has this person known you?

2) Teacher, Clergy, etc.

Name

Telephone (daytime)

Telephone (evening)

In what capacity?

How many years has this person known you?

3) Volunteering Supervisor

Name

Telephone (daytime)

Telephone (evening)

In what capacity?

How many years has this person known you?

6. Submit application

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

If you would only like your application and resume forwarded to one particular Community or Region (Ontario Region, Quebec Region, Atlantic Region, Western Region), please name the Community or the region and provide a brief explanation for this decision.

E. 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. 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.

I have read and accept Part E above *

No Yes