Live-In Caregiver Employer (Page 2 of 7) in pdf

Live-In Caregiver Employer Page 2

Street address: ___________________________________________________________

City: __________________ Province/Territory: _______________ Country: __________

Postal Code: _____________

Telephone (home): __________ Telephone (work): ___________ Email: _____________

EMPLOYEE’S PLACE OF WORK

NOTE: Under the Live-in Caregiver Program, only work that has been completed in Canada under a valid work

permit is considered toward the live-in caregiver’s work requirement for permanent residence. Any work completed

outside Canada will not be counted.

Will the EMPLOYEE work at EMPLOYER’s residence in Canada as indicated above?

Yes

If no, provide the details of where the EMPLOYEE will work and reside (must be in the residence in Canada of the

person receiving care):

Street address: ___________________________________________________________

City: __________________ Province/Territory: _______________ Postal Code: _______

Telephone (home): _________________ Telephone (work): _________________

Email: ___________________

Description of the house and the household

Total number of rooms: _________

Total number of bedrooms: ______

Details of all household members (ALL adults and minors residing in the house):

Surname

Given name(s)

Age

If more space is required, add an annex to this contract and cross-reference.

The PARTIES agree as follows:

Live-In Caregiver Employer Page 2