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Please fill out the forms

Please ensure to complete all required fields in the following forms:

Application Form
Equality & Diversity Form
Data Sharing Form
48hr Opt Out Form

Forms

Application Form

First Name *

Last Name *

Email *

Phone

Street Address

Street Address 2

City

County

ZIP / Postal Code

Country

Date of birth *

Have you got your driving license?

Have you got your own transport?

Upload your CV

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Gender *MaleFemale

Have you got a DBS on the Update System? Please provide your reference number. *

If you do not own a enhanced DBS on the update system you are required to apply for one, please state if you would like to apply for a DBS with our company (it incurs a fee payable by applicant) *

How many Years/Months experience in care? *

Please provide a full five years history of work placements. Do not leave any gap, if there is a gap, please explain why you were off work. Please be accurate with the dates of work history dates, avoiding this application from being voided. *

Please provide the care settings you are most familiar with, include the skills you have and skills you would like to develop. If you never worked in care please provide the skills you believe that can be brought to the care setting.

Reference 1Please provide reference 1

First Name *

Last Name *

Email Address *Ensure you provide their email address

Phone *Ensure you provide their phone number

Position within the company or relation to you

Reference 2Please provide reference 2

First Name *

Last Name *

Email Address *Ensure you provide their email address

Phone *Ensure you provide their phone number

Position within the company or relation to you

Please provide details of your next of kin, relationship to you, address and phone number: *

What is your Nationality? *

Are there any restrictions to your residence in UK which may affect your right to work in UK? *

If you are on a visa, please provide the date it expires.

Please provide your Bank account and sort code for future payments:

Please provide your National Insurance Number: *

Please provide Your Self Employed UTR if applying for a Self Employed Job:

Please declare all criminal convictions, whether spent or not, warnings and cautions bellow ( state none to declare if you have not got any): *

Please sign the declaration: I declare to the best of my knowledge and belief the information given in this application is true, if any of the information supplied by me is found to be falsely declared, my contract may have been fundamentally breached and may be terminated as a consequence. *

Please sign the declaration: I understand that i may not be offered a post until satisfactory response has been received with respect to my DBS register status, and that should i subsequently be offered a post, subject to two satisfactory references, one of which should be from my previous employer and that confirmation of the employment will be subject to a satisfactory criminal record check from the DBS. I also understand that until a satisfactory response is received from DBS, and my employment is confirmed, i will be supervised at all times at work and will not seek or have unsupervised access to vulnerable people. *

Please sign the declaration: I authorize ICare Network Ltd, to request a DBS Register check and a criminal record check from the DBS, on initial employment and at any time during my employment thereafter. I undertake to inform my employer immediately if my DBS Register status or criminal status changes at anytime during my employments such as by being charged with an offense (other than motoring offenses), the administration of a warning, criminal conviction, referral to any register of barred Care workers, or withdrawal of any registration required by my employment status: *

Please sign the declaration: (For Registered Nurses only) If the post i have applied for is as a Registered Nurse, my confirmation of employment will also be subject to a satisfactory search of the Nursing and Midwifery Council records and registers, please give permission for this procedure to take place.

Signature *

Forms

48hr Opt Out Form

Under the Working Time

Regulations 1998 a worker’s average weekly working time (including overtime) calculated over a rolling 17 week period must not exceed 48hrs. The Regulations provide that this limit will not apply where a worker has agreed with their Employer, in writing, that this should not apply in their case.

I am therefore asking you to agree opt out to enable you to decide on your own hours of work.

You may withdraw your agreement by giving the Company three months advance notice in writing. Please confirm your agreement by signing where indicated on the section below.

Yours Sincerely
For and on behalf of EverBright Homecare
Maria Baptista

Give your loved ones the care they deserve

Contact Details

Got questions? Reach out to us directly

If you would like to know more about our care services please contact us. We will organise an assessment meeting date if you wish and tailor your care plan based on your needs and wishes. Everything is very straightforward and there are no hidden fees. Visits can be cancelled on a 24 hour basis.

Application

Forms

Please fill out the forms

Application Form

Equality & Diversity Form

48hr Opt Out Form

Give your loved ones the care they deserve

Got questions? Reach out to us directly

Call Us

Email Us

Visit Us

get in touch

Quick Links

get in touch

Care Quality Commission

Application

Forms

Please fill out the forms

Application Form

Equality & Diversity Form

Data Sharing Agreement between the named staff and EverBright Homecare Ltd

48hr Opt Out Form

Give your loved ones the care they deserve

Got questions? Reach out to us directly

Call Us

Email Us

Visit Us

get in touch

Quick Links

get in touch

Care Quality Commission