Your Name*
Your Email*
Your Address*
Your Phone Number*

(Residential) Child & Youth Worker Positions:
Youth Residential ProgramChild & Youth Care Worker

Residential Support Worker Positions:
Adult Residential ProgramSemi Independent Living

Community Support worker Positions:
Outreach SupportSupported/Customized EmploymentCommunity-Based Day Services

Availability: Please select all areas that apply. Shifts may vary depending on the program.

Have you previously worked for Milieu? YesNo

If yes, Dates of Employment:

If yes, What position?

Tell us what you know about Milieu:

Milieu uses "person centered" approaches with the people we support. what do you think this means?

Are you legally entitled to work in Canada? YesNo

If you have a work permit, what is the expiry date?

How did you learn about Milieu? —Please choose an option—Milieu WebsiteOnline Job BoardJob FairIndeedOther

If Other, Please specify:

Do you currently have a family member working for Milieu? YesNo

If hired, when would you be able to start working?

If hired, do you have reliable means of transportation to go to work? YesNo

What Class of Driver's License do you have?

Have you ever had a TB test?YesNo

If Yes, what was the result?

Are you willing to undergo a local and provincial criminal record check prior to employment?YesNo

Certificates/Diplomas: Please list your certifications/diplomas including dates of completion. Prior to hire, proof of education and training is required.

Relevant Experience: Are there any other relevant experiences, skills or qualifications which you feel would apply to employment with Milieu?

Reference Name:
Reference Title/Position:
Phone:
Email:
Company:
Address:
Dates of Employment:
Position Held:
Reason you left:

Reference Name:
Reference Title/Position:
Phone:
Email:
Company:
Address:
Dates of Employment:
Position Held:
Reason you left:

Name:
Relationship:
Phone:
Email:

Resume*

Cover Letter*