Employment application form (#12)Vitalis Comprehensive Healthcare & Vitalis Surgical CentreEmployment Application FormThank you for your interest in joining Vitalis Comprehensive Healthcare & Vitalis Surgical Centre. Please complete all sections of this application. All information is confidential and will be used solely for employment consideration.Availability & Work PreferencesAvailability to StartEducation & CredentialsHighest Level of Education Completed- Select -High School Diploma (Grade 12)Health Care Aide CertificatePost-Secondary Certificate (Medical / Healthcare Field)Diploma – Practical Nursing (LPN)Diploma – Medical Office Assistant / Unit ClerkDiploma – Surgical / Operating Room TechnicianDiploma – Sterile Processing (MDR Technician)Diploma – Allied Health ProgramAdvanced Diploma – Healthcare FieldBachelor’s Degree – Nursing (BN / BScN)Bachelor’s Degree – Health Sciences / Allied HealthBachelor’s Degree – Other FieldPost-Graduate Certificate – Healthcare SpecializationMaster’s Degree – Nursing (MN / NP)Master’s Degree – Health Sciences / Physician AssistantDoctoral Degree (MD / PhD / Equivalent)International Medical Graduate (IMG Professional Designations / Certifications Certification Expiry Date Institution(s) Attended Institution Year Degree / Diploma earned Healthcare & Surgical ExperienceTotal Years of Healthcare Experience Employer(s) Starting from most recent one Employer Name Start Date End Date ReferencesTwo Professional References, including Name, Title, Organization, Phone, and Email References Name Title Organisation Email Phone Submit Form
