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Recruitment Application Form

Personal Information

Date of Birth
Day
Month
Year
Do you smoke / vape?
Yes
No
Are you happy not to smoke / vape at work?
Yes
No
Are you able to assist with personal care?
Yes
No

e.g. washing, dressing and helping with using the toilet?

Are you happy to prepare meals?
Yes
No

They may involve cooking from ready meals or scratch with instructions.

Are you happy to work for clients with pets?
Yes
No

If not, or for some pets, please specify.

If a client requests alcohol, such as wine or beer, will you serve it in moderation?
Yes
No
Can you start at 7 am if clients request it?
Yes
No
We want our team to work on some weekends. Please confirm if you are available to work on alternate weekends.
Yes
No
If we need extra shifts covered, could you help?
Yes
No
Do you have the right to work in the UK?
Yes
No
Do you have a full British drivers license?
Yes
No

Education, Qualifications & Training

e.g. experience working with dementia people, Alzheimer's, challenging behaviours etc.

e.g. NVQs, manual handling, medications, etc.

Work History

Are you currently in employment?
Yes
No

Please rest assured that this will remain confidential unless you approve and are happy for me to contact them.

Please provide previous work history below:

References

Feedback

e.g. Facebook, Google, Job Centre

Do you know anyone who had worked for Gould Care?
Yes
No

Documentation

e.g. passport, driving license

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