Graceful Care Giver - Home Care Service

1/5: Basic Information

What's your gender? *
Male
Female
Prefer not to say

Please select your gender.

Home Address *

Please provide your home address.

Position Applied For *

Please select a position.

Work Preference *
Full Time
Part-Time
Bank

Please select your work preference.

I understand this role may include: Shift work, Unsociable Hours, Lone working involved. *
Yes I agree

You must agree to this statement.

Availability *

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Please indicate your availability.

2/5: Personal Details

First Name *

Please enter your first name.

Surname *

Please enter your surname.

Maiden Name

Previous Names

Marital Status *
Married
Divorced
Prefer not to say

Please select your marital status.

Place of Birth

Mobile Number *

Please enter your mobile number.

Nationality *

Please enter your nationality.

NI Number *

Please enter your NI number.

Email Address *

Please enter your email address.

Are you a Driver? *
Yes
No

Please indicate if you are a driver.

Own Transport *
Yes
No

Please indicate if you have your own transport.

Are you a United Kingdom (UK) National? *
Yes
No

Please indicate if you are a UK national.

If no, please detail your current immigration status and the relevant visa currently held (including Visa number)

Are you related to any of our current members of staff or Service Users? *
Yes
No

Please indicate if you are related to any staff or service users.

Equality Act 2010 - For the purposes of this application and interview stage only, is there anything you would like us to be aware of so that we can make reasonable adjustments during the process?
Prefer not to say
Yes

Please indicate if you need any adjustments during the process.

If Yes Above

3/5: Education

School / College / University *

Please enter your school, college, or university.

Date From *

Please enter the start date.

Date To *

Please enter the end date.

Examinations, Qualifications *

Please list your qualifications.

4/5: Employment History

Current / Most recent employer *

Please enter your current or most recent employer.

Start Date *

Please enter the start date.

End Date *

Job Role *

Please enter your job role.

Reason for Leaving

Duties *

Please describe your duties.

Contact Name *

Please enter a contact name.

Telephone *

Please enter a contact telephone number.

Email *

Please enter a contact email address.

Explanation of Gaps

5/5: References & Declaration

Please confirm that you will be able to provide us with suitable references upon request via our electronic reference system *
Yes
No

Please confirm if you can provide references.

Are you currently bound over or do you have any current UNSPENT convictions? *
Yes
No

Please indicate if you have any unspent convictions.

Do you have a current DBS/DBS on update service? *
Yes
No

Please indicate your DBS status.

Privacy Statement *
I have read and agree to the Privacy Policy

You must agree to the privacy statement.

Declaration *
The information in this application form is true and complete.

You must agree to the declaration.

Careers at Graceful Care Giver

Join Our Team

1/5: Basic Information

2/5: Personal Details

3/5: Education

4/5: Employment History

5/5: References & Declaration

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