Care Worker Application Form - Carers at Home

I understand and accept the information I provide will be recorded on Carers at Home’s systems and processed in line with UK GDPR and the Data Protection Act 2018, including any additional information or documents you supply.

Yes

No

Last name

First name

Phone

Email

Address

Please ensure the adress is full including, town, county and postcode

Do you require sponsorship from Carers at Home to work in the UK?

Yes

No

Please briefly explain your right to work in the UK

Do you have a valid UK driving licence?

Yes

No

Do you have access to a car you can use for business purposes?

Yes

No

What type of work are you looking for?

Domiciliary care

Live in care

Either domiciliary care or live in care

Please provide a brief description of the work you are looking for.

Please include things such as full time, part time, number of hours, evenings, weekends etc?

What is it that attracts you work in the care sector?

Please explain why you would like to work for Carers at Home

How many years of care experience do you have?

How many previous jobs have you had?

What is the earliest date you could start?

Have you ever been convicted by the courts or cautioned, reprimanded or given a final warning by the police?

yes

No

Because of the nature of the work involved, the position for which you are applying is exempt from Section 4(2) of the Rehabilitation of Offenders Act 1974.

This means that all convictions, cautions, reprimands and final warnings, whether spent or unspent, must be disclosed.

Any information provided will be treated confidentially and will be considered only in relation to the requirements of the role. Disclosure of a criminal record will not automatically prevent employment

Please provide details of the criminal record

Please provide a brief overview of any care related training

Please provide a brief overview of your education to date

Please include things such as school, college or university attended and the qualification chieves such as GCSE, NVQ and A-levels

Is there any other information you would like to add?

Reference 1

Please provide the name, company, address, company e-mail and telephone number of 1 person who can provide you with a professional reference. Please also provide a brief summary of your relationship with them and when and where you worked with them

Reference 2

Please provide the name, company, address, company e-mail and telephone number of 1 person who can provide you with a professional reference. Please also provide a brief summary of your relationship with them and when and where you worked with them. If you are unable to provide a second reference please explain why

I confirm that I am happy for Carers at Home to contact the referees listed above.

Would you like to add any documents to your application?

Yes

No

File upload

Please upload a maximum of 5 documents

The personal information you provide will be processed by Carers at Home for recruitment and pre‑employment purposes only, including assessing suitability and carrying out necessary checks, in accordance with UK GDPR and the Data Protection Act 2018.

I accept

I do not accept

I confirm the information provided is true to the best of my knowledge. If found to be false or misleading, this may result in withdrawal of an offer or dismissal.

Yes

No

Signature

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