Thank you for your interest in applying.

Before beginning:
Please review the form below and gather all the information required.

Completing the Form:
You can "copy and paste" information out of a Word document into this form.

Save and Continue:

You can "Save and Continue" to continue working on the form at a later time. Click "Save and Continue" and copy the unique link that appears on the screen (in the Message from Inclusion Selkirk area below these instructions).  Alternatively, you can enter your email and have the link sent to the email you choose.

Ready to proceed? When you are ready to restart the form paste the unique link into your browser window or alternatively click on the link contained in the email you chose to have sent to you.

Submit Your Application Form:

Click on the "Submit" button at the bottom of the form. A confirmation message will appear in the Message from Inclusion Selkirk area below. A confirmation email containing the details of your application will be sent to the contact email you have entered. If you do not receive this email within 24 hours please contact Shannon Bucholz. Please check your Spam folder before contacting us.

Message from Inclusion Selkirk (N.B. content will only appear after application form either Saved or Submitted)

JOB APPLICATION FORM

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Are you able to travel to Selkirk for work? All our positions are located within Selkirk, MB. If no, please do not continue.

REGISTRY CHECKS

A clear criminal record/child abuse and adult abuse registry check are required to be employed.

If you have a current criminal record check, child/adult abuse checks they must be less than 3 month old to be considered valid.

If you do not have these checks they will be required as part of the hiring process and we will provide you with information needed to obtain the checks.

If you have a criminal record and wish to apply you will need to disclose your history of charges and dates and proceed with an in-depth check utilizing fingerprints – if you are willing to do this please provide full details on your criminal charges along with year so we can determine if they exclude you from employment.

Do you currently have any of the checks below? See information above.

LANGUAGES SPOKEN AND WRITTEN

English(Required)

CONTACT INFORMATION

Name(Required)

PHYSICAL ADDRESS

Mail to:(Required)

HISTORY WITH INCLUSION SELKIRK

Have you interviewed with us before, either as Inclusion Selkirk or perhaps when we were known as Community Living Selkirk?(Required)
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Have you worked for us before, either as Inclusion Selkirk or perhaps when we were known as Community Living Selkirk?(Required)

AVAILABIITY

When are you able to work? Please check all that apply.(Required)
What hours are you applying for?(Required)
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Do you have a valid Manitoba driver's licence?(Required)
Are you comfortable and physically able to provide individual personal care, e.g. supporting lifts and transfers, bathing, toileting and general daily healthcare routines.(Required)

EDUCATION

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Certificates Held(Required)

EMPLOYMENT HISTORY

Position 1

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May we contact your current/previous employer?

Position 2

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May we contact your current/previous employer?

Position 3

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May we contact your current/previous employer?

REFERENCES (Please supply 2 references.)

Name(Required)
Name(Required)