* First Name

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* Are you currently registered with the College of Nurses of Ontario? Select Answer Yes No New Graduate - Working Towards Internationally Trained - Working Towards Registered Out of Province

* If you are currently registered with the College of Nurses of Ontario please provide your registration number. If not, enter N/A

* Have you ever undergone an investigation for disciplinary proceedings with the College of Nurses? Select Answer Yes No

* Do you have a preferred name?

* Are you a current employee? Enter your employee number (found on your paystub). If no, type N/A

* Have you ever been convicted of a crime for which you have not been pardoned for? Select Answer Pardoned/Clean Record I have been convicted but have not yet been pardoned

* Are you able to provide proof of immunization and vaccination? Select Answer Yes No I have medical accommodation

* Are you eligible to work in Canada? Select Answer Yes Not at this time Working towards

* I confirm that the information I provided including my resume and answers to listed screening questions is factual and up to date. Select Answer Yes No

* Are you able to meet the scheduling requirements as listed on the job posting? Select Answer Yes No

* I understand that this position would require me to work onsite at Muskoka Algonquin Healthcare. Select Answer Yes No

* I understand that applicants must reside within 125km of one of our hospital campuses or be willing to relocate prior to start. *exceptions will be considered on a case-by-case basis Select Answer Yes No

* Resume / CV Upload