Municipality of Chatham-Kent 2008 RPN Call-in Application Form Job # SS 08-23 Health & Family Services Seniors Services Please include this application to your cover letter and resume. If you are submitting a hard copy of your cover letter and resume, please staple this application form to the front of your cover letter. Applications will be accepted starting April 1, 2008, for a period up to June 30, 2008. Please only apply once during this period. Original applications received between April 1 and June 30, 2008, will be kept on file for consideration for positions that become available during this period. Please visit JOBS at www.chatham- kent.ca for re-application information following June 30, 2008. PLEASE PRINT: Name: (last) (first) (middle initial) Address: 911 Address Apartment/Unit # PO Box Rural Route City/Town Postal Code Telephone: Home ( ) - Cell ( ) - Work ( ) - Email address: Please check all qualifications that apply: Possess secondary school diploma Graduate of a Registered Practical Nurse program Registered with the College of Nurses of Ontario as an RPN Possess pharmacology certificate Computer keyboarding skills Successful candidate will be required to furnish a clear police check, prior to commencing employment. Do you have experience in any of the following areas? (include specific experience in your resume) Caring for the elderly Working in a Long Term Care setting Assessing, planning, implementing and evaluating care of patients Applicant information is collected under the authority of the Municipal Freedom of Information and Privacy legislation and will be used strictly for the purpose of candidate selection. We thank all candidates in advance; however, only those candidates selected for an interview will be contacted. The Municipality of Chatham-Kent is an equal opportunity employer.