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Personal Information
Questionnaire

About Me (short bio)*

Please write a short paragraph that will enable people who are reading it to 'get to know you'. You may want to include details about experience, qualifications or even your hobbies.

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Number of years care experience*

Please let us know the number of years experience you have in care work.

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Which care categories are you able to work in?*

Please let us know which care domains you are able to work in.

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Which age categories are you able to work in?*

Please let us know which age categories you are able to work with.

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Which care domains are you able to work in?*

Please let us know which care domains you are able to work in.

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What is your hourly rate?*

Please let us know your preferred hourly rate for work of a standard nature and at a standard time. Please note we recommend you do not charge less than £10 per hour.

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What times are you available for work?*

Please let us know which times you are available to work.

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What level are you educated to?*

Please let us know which educational achievements you have.

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Do you hold a Skills for Care Certificate?

We recommend if you don't already have, all care and support workers work towards gaining the Skills for Care Certificate

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What is your home address postcode*

Please indicate your home address postcode or the postcode of the base you intend to work from.

Maximum travel distance*

Please let us know the maximum distance you are willing to travel to visit a client.

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Do you have a valid driving license?*

Please let us know if you have a current, valid driving license.

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Do you have your own insured vehicle to use with clients?*

Please let us know if you have your own insured vehicle which can be used with your clients.

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Are you DBS checked?*

We always recomend care workers have the necessary level and upto date DBS check.

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Year of last DBS check*

Please let us know the year of your last DBS (formerly CRB) check.

Level of DBS check*

Please let us know the level of your last DBS (formerly CRB) check.

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Any activity listed against you since DBS check?*

Please let us know is there is any activity listed against your name since your last DBS check.

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Are you legally entitled to work in the UK?*

Please let us know if you are legally entitled to work in the United Kingdom.

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Do you have work insurance?*

Please note that care workers are legally required to have adequate insurance. Please indicate whether you already have insurance or if not please indicate that you understand you are legally required to have insurance before commencing work.

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Are you able to produce work references?*

Please let us know if you are able to produce at least 2 work references for prospective clients.

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Are you male or female?*

Please let us know if you are male or female.

Please indicate your gender
 
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