FAMILY-RUN
INDEPENDENT
TRUSTED
25
ESTABLISHED 25 YEARS

Home Care Assistant Application Form

Section One: Personal Details

I am applying for:
I am applying for: *
Full-time
Part-time
Weekends
Nights
Evenings
No Preference
No Preference
Are there any days you would prefer not to work? *
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
No Preference
Please select are you available to work weekends?
Please select are you available to work weekends? *
Yes
No

* All of our Home Care Assistants are required to work at least one weekend in every two.

Section Two: Education

School / GCSE / A-levels

Higher education / College / University

Section Three: Previous Employment

Most Recent Previous Employment

Other Previous Employment

Other Previous Employment

Section Four: References

Please give the name and address of two people from whom we can obtain a reference.

Please note that one reference needs to be from the manager of your last or present employer, at a business address.

Reference 1 (Professional reference)

Personal Reference

Section Five: Rehabilitation of Offenders Act 1974, and criminal records

Please select have you ever been convicted of a criminal offence?
Please select have you ever been convicted of a criminal offence? *
Yes
No
Please select have you ever been cautioned or issued with a formal warning regarding any criminal offence?
Please select have you ever been cautioned or issued with a formal warning regarding any criminal offence? *
Yes
No

Section Six: General Information

Please select do you hold a current full uk driving licence (or another licence that entitles you to drive in the uk)?
Please select do you hold a current full uk driving licence (or another licence that entitles you to drive in the uk)? *
Yes
No
Please select do you own or have access to the use of a car?
Please select do you own or have access to the use of a car? *
Yes
No
Please select do you have business cover on your vehicle insurance?
Please select do you have business cover on your vehicle insurance? *
Yes
No
If the answer to the above question is no, you should contact your insurance provider and arrange business cover as soon as possible. This should not cost any extra with most insurers.
Please select are you registered under the disabled act?
Please select are you registered under the disabled act? *
Yes
No
Please select do require a work permit to take employment in the uk?
Please select do require a work permit to take employment in the uk?
Yes
No

If the answer to the above question is yes, please answer the following questions. Otherwise go to Section Seven.

Please select do you hold a current work permit?
Please select do you hold a current work permit?
Yes
No

You have an automatic right to work if you are a citizen of the U.K., European Union and E.E.A and certain Commonwealth countries.

Please select do you need permission to work in the uk?
Please select do you need permission to work in the uk?
Yes
No

If yes, please answer questions below. Otherwise go to Section Seven.

Please select are you visiting the uk on a working holiday?
Please select are you visiting the uk on a working holiday?
Yes
No
Please select do you hold a student visa?
Please select do you hold a student visa?
Yes
No
Please select have you recently been resident outside the uk?
Please select have you recently been resident outside the uk?
Yes
No

Section Seven: Declaration

The information I have given in this application form is, to the best of my knowledge, complete and accurate in all respects.

I understand that to knowingly give false information will disqualify me from being employed by Clarendon Home Care.

I understand that to legally work for Clarendon Home Care, I will need a C.R.B. check certificate which remains my property and agree to pay the costs of the C.R.B. check if I am offered employment.

How can the Clarendon Live-In Care family help your family?

All live-in care starts with a conversation so that we can get to know more about you and your unique circumstances. Get in touch now with a member of our live-in care team and let us help you with the planning and cost of live-in care at home.

Request a callback

Speak in confidence to a member of our team for an obligation-free chat about your live-in care needs.

call me back

Request a home visit

We’ll arrange for one of our expert team to come and visit you at home to discuss your live-in care needs.

visit me at home

Download a brochure

Read a digital copy of the Clarendon Live-In Care brochure and learn more about how our award-winning live-in care services could be right for you.

Download the brochure

Request a brochure

Get in touch and we’ll pop a copy of the Clarendon Live-In Care brochure in the post for you to look at in your own time.

post me the brochure
Arrange Call-Back X

Send us your contact details and we’ll call you back…

Thank You

Your message has been sent to us and we will call you back as soon as we can!

THIS WEBSITE USES COOKIES

We use cookies, which are small text files, to improve your experience on our website and to show you personalised content. You can allow all or manage them individually.

Privacy Policy | Cookie Policy

Essential
Analytics
Advertising
Personalisation
  • Overview
  • Essential [4]
  • Analytics [3]
  • Advertising [0]
  • Personalise [0]
  • Other [0]

Cookies are small text files that can be used by websites to make a user's experience more efficient. The law states that we can store cookies on your device if they are strictly essential for the operation of this site. For all other types of cookies we need your permission. This site uses different types of cookies. Some cookies are placed by third party services that appear on our pages.

You can at any time change or withdraw your consent from the Cookie Declaration on our website. Learn more about who we are, how you can contact us and how we process personal data in our Privacy Policy. Please state your consent ID and date when you contact us regarding your consent.

Essential cookies help make a website usable by enabling basic functions like page navigation and access to secure areas of the website. The website cannot function properly without these cookies.

Cookie Provider Info Duration
cookies_closedUnknown24 Hours
_gaexpUnknown24 Hours
BMOD_COOKIE_CONSENTb:mod ThemeUsed to determine if the user has accepted the cookie consent popup provided by the b:mod theme2 Years
bcookies_acceptanceb:cookiesUsed to store your cookie preferences for this site2 Years

Personalisation cookies enable a website to remember information that changes the way the website behaves or looks, like your preferred language or the region that you are in.

Cookie Provider Info Duration
We are not using cookies of this type at the moment!

These cookies gather anonymous information such as how many people are using our site or which pages are popular to help us improve customer experience. Switching off these cookies will mean we can’t gather information to improve the experience.

Cookie Provider Info Duration
_gat_gtag_%Google AnalyticsUsed to set and get tracking data24 Hours
_gaGoogle AnalyticsUsed to store a unique client identifier ID (randomly generated number) that is used to generate statistical data on how the visitor uses the website.2 Years
_gidGoogle AnalyticsUsed to store a unique client identifier ID (randomly generated number) that is used to generate statistical data on how the visitor uses the website.24 Hours

Advertising cookies are used to track visitors across websites. The intention is to display ads that are relevant and engaging for the individual user and thereby more valuable for publishers and third party advertisers.

Cookie Provider Info Duration
We are not using cookies of this type at the moment!

Unclassified cookies are cookies that we are in the process of classifying, together with the providers of individual cookies.

Cookie Provider Info Duration
We are not using cookies of this type at the moment!