Supporter Application Form
  • HomeSupporter Application Form

  • Date of Birth*
     - -
  • Format: (000) 000-0000.
  • RIGHT TO WORK VERIFICATION

  • The applicant must provide original documentation.
  • Right to Work Documentation
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  • DBS VERIFICATION

    Please note that if you do not have a current Enhanced DBS certificate that is registered with the DBS Update Service, we will arrange an application on your behalf and a fee will apply.
  • DBS Level Provided:
  • Issue Date:
     - -
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  • Are you registered with the Update Service?
  • SELF-EMPLOYMENT STATUS

  • Are you registered as Self-Employed with HMRC?
  • The applicant confirms responsibility for registering as see further details about being Self-Employed with HMRC

  • As a Self-Employed person I acknowledge I am responsible for:*
  • INSURANCE DETAILS

  • Do you currently hold a Public Liability Insurance?*
  • Information on Public Liability Insurance

  • Expiry Date:
     - -
  • Services you are prepared to offer: (Tick all you are happy to help with; this list an indication of the type of requests not an exhaustive list)
  • Would you be prepared to offer Personal Care? ( to be discussed at interview)
  • EXPERIENCE & BACKGROUND

  • Previous Domestic / Support Experience:
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  • AVAILABILITY

  • When can you offer help?
  • DRIVING

    Not essential
  • Driving Licence Held:
  • Own Vehicle:
  • FINAL DECLARATION

  • I confirm that:

    • The information provided is accurate and complete.
    • I understand I will be engaged directly by the client as a self-employed contractor.
    • I will not undertake any regulated personal care activities.
  • Date:
     - -
  • Should be Empty: