Nurse Registration formFirst NameMiddle NameLast NameEmail AddressusernamepasswordDate of birthgendermalefemalePrefer not to sayNationality / Citizenship StatusCanadian CitizenPermanent ResidentWork Permit HolderOther (please specify)Languages Spoken * (Select all that apply)ArabicChineseEnglishFrenchIndianItalianPersianSpanishTurkishOther (please specify)Level of English Proficiency *FluentGoodBasicPhoneStreet AddressApartment, suite, etcCityState/ProvinceZIP / Postal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweProfessional Designation / Qualification * (Select all that apply) Please select the highest or most relevant qualification.Personal Support Worker (PSW) – Certified college-trained PSWHealth Care Aide (HCA) – Certified HCA (equivalent to PSW in some provinces)Senior Caregiver – Experienced senior caregiverCompanion Caregiver – Focus on companionship, conversation, and emotional supportHome Support Worker – Focus on homemaking and household supportLive-in Caregiver – Experienced live-in caregiverOther (please specify)Name of College / Training InstituteGraduation YearRegistration / Certificate Number (if applicable)Expiry Date (if applicable)Years of Experience in Senior Care * (in years)Personal CareBathing, Showering & GroomingDressing & Undressing AssistanceToileting & Incontinence CareMobility Assistance & TransferringFall PreventionHomemakingLight Housekeeping & CleaningLaundry & Bed ChangingMeal Preparation & CookingGrocery Shopping & ErrandsNon-Medical Health SupportMedication RemindersVital Signs Monitoring (Blood Pressure, Blood Sugar – recording only)Post-Hospital Recovery SupportChronic Condition Support (Diabetes, Heart Disease, Arthritis, etc.)Companionship & WellnessEmotional Support & ConversationGames, Reading, Music & Brain ActivitiesLight Exercise & WalkingTransportation to AppointmentsReducing LonelinessOtherDementia / Alzheimer’s CareLive-in Care ExperienceCPR / First Aid Certified (with expiry date)Type of Position Interested In * (Select all that apply)Full-timePart-timeCasual / ReliefLive-inOvernight ShiftsHourlyAvailability (Days and Hours) *Preferred Hourly Rate (CAD) *Do you have a valid driver’s license and reliable vehicle? *yesnoMaximum distance willing to travel (km)Profile Photo * Guidelines:• Clear, professional headshot facing the camera • Good lighting and simple background • No sunglasses, hats, filters • Maximum file size: 5 MBChoose FileNo file chosenDelete uploaded fileAbout Yourself (Bio) * (Minimum 150–200 characters)Certificates & Documents (Upload multiple files allowed)Drag and Drop (or) Choose FilesResume / CV (Optional but recommended)Choose FileNo file chosenDelete uploaded fileVulnerable Sector Check (VSC) / Police Record Check: A clear Vulnerable Sector Check is required for all caregivers working with vulnerable seniors and must be issued within the last 6 months.Yes, I have a valid VSC (Upload document + Date of Issuance)No, I don’t have one yet – I will obtain and upload it laterFinal ConfirmationI agree to the Terms of Service and Privacy PolicyAll the information I provided is true and accurate.I understand that CuraCaregiver is a matching platform and not an employer.Submit
