Become a Carer Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 5Full Name *Email Address *Phone Number *What city are you in *ChristchurchTaurangaWhat's your address *What's your country of birth *Date of Birth *Do you have the legal right to work in NZ? *YesNoNextInterests and Hobbies *When supporting a client, what feels most natural to you? *I enjoy chatting and building rapportI’m comfortable with a balance of chat and quietI’m happiest supporting quietly and respectfullyHow do you usually support people best? *I’m proactive and like to take initiativeI work best collaboratively, checking in as I goI prefer to support quietly and only step in when neededWhy do you want to work for us? *PreviousNextWhich days can you work? *MondayTuesdayWednesdayThursdayFridaySaturdaySundayWhich times are you available? *Morning (AM)Afternoon (PM)Evening (PM)Overnight / SleepoverWhen could you start if work becomes available? *ASAPWithin 2-4 WeeksOver 1 MonthHow many years of industry experience do you have? *0-1 years1-3 years3+ years Referee Email hold Which areas do you have experience in? *Dementia CareParkinsonsDaily Home CareOvernight SupportNurse Level CareRest Home CareMobility SupportPersonal CareDo you have Industry Qualifications? *YesNoDo you hold a First Aid Certificate? *YesNoDo you hold a full driver’s licence? *YesNoDo you have vehicle insurance? *YesNoAre you comfortable working independently? *YesNoPreviousNextDetails of Referees (employer or personal) : Please give details of two referees whose consent has been obtained and who may be contacted for a confidential reference. Where possible, at least one referee should be able to give work-related information. Referees Referee 1 - Full Name *Referee 1 – Relationship to you *Referee 1 – Email Address *Referee 2 - Full Name *Referee 2 – Relationship to you *Referee 2 – Email Address *PreviousNextDeclaration I declare that all the information I have given is true and that any false or misleading information may result in termination of contract with HOME CARE SERVICES. I understand that all information provided by me will be held on a confidential basis and that my permission will be sought before any identifying personal details are released to a third party. I consent to HOME CARE SERVICES undertaking reference checks pursuant to my application for a specific employment position, and recognise that all conducted on a confidential basis, and that HOME CARE SERVICES has the right to maintain confidentiality of this information. I declare that all information provided by me to HOME CARE SERVICES in this Independent Contractor Application is true, accurate and complete and is not designed to mislead in any way. Declaration *I confirm that I have read and understood the statements in the declaration above.Submit
