Health Care Support Worker Application Form

If you would like to alternatively email us your CV and a short statement with regards to any experience you have and why you want to work in health and social care our email address is:

[email protected]

Health Care Support Worker Application Form

Please answer all the questions in full to the best of your ability - any difficulties should be discussed with a member of the ProCare Management Staff. Your application form may be subject to scrutiny by Local Authority Accreditation Bodies and the Care & Social Services Inspectorate Wales.

"*" indicates required fields

Step 1 of 3

SECTION A: PERSONAL DETAILS

(Married/Single/Widowed/With Partner)

Availability

(Please tick which days, nights and weekends you will be available to work, and write the number of hours per day)
Mon
Mon
Tue
Tue
Wed
Wed
Thur
Thur
Fri
Fri

Weekends

Saturday
Saturday
Sunday
Sunday

Section B: EDUCATION & TRAINING

If you have an up-to-date C.V. please submit the file in the box below, otherwise complete Section B in full. Your C.V. must contain the following information: Please account for ALL gaps in your employment history, however short Name and address of ALL employers since leaving full-time education, stating the reason for leaving each position All qualifications gained (including any obtained through work or other bodies) All secondary schools, colleges or other training institutions attended
Accepted file types: jpg, gif, png, pdf, Max. file size: 2 MB.

School history

All secondary schools, colleges or other training institutions attended.

Colleges and Universities

Training

Qualifications

(List all qualifications & certificates gained, including any obtained through work or other bodies)

SECTION C: EMPLOYMENT HISTORY

Please supply the names and addresses of ALL employers since leaving full-time education, stating the reason for leaving each position. Start with your CURRENT EMPLOYER FIRST and work your way down to the earliest. Please also account for any gaps in your employment history in the space provided.

CURRENT EMPLOYMENT

PREVIOUS EMPLOYMENT

Previous employment 1

Previous employment 2

Previous employment 3

Explanation of Gaps in Employment

Explanation of gaps in employment please include dates.
Explanation of gaps in employment please include dates.
Explanation of gaps in employment please include dates.

For Office Use Only

Verification of Gaps in Employment: The Compliance Officer or their deputy must contact all previous employers in the care sector noted above to confirm that the employment details given by the applicant are accurate. This should be noted and signed-off below:

SECTION D - PERSONAL STATEMENT

Please tell us in as much detail as possible what you could bring to the role of support worker if you were successful and why you are applying for this position.

SECTION E: EMPLOYMENT & CHARACTER REFERENCES

We require a minimum of 2 references. Your first reference MUST be from your previous employer (unless there are extenuating reasons why such a reference cannot be obtained). You may not use a relative as a referee.

Applications from ex-offenders are welcome and will be considered on their merit. Convictions or cautions that are irrelevant to the job will not be taken into consideration but you are required to disclose ALL convictions or cautions (including 'spent' convictions) by virtue of the rehabilitation of offenders act (Exceptions) Order 1975. Successful applicants will be required to undergo an enhanced DBS check.