Application Form


Interested in joining our team? We would love to hear from you!

Fill in the form below with your details and we will get back to you.

    Do you need a work permit to work in the UK?*

    Driving on behalf of Ashwell Home Care Services

    Do you have a car driving licence?*
    Do you have regular access to your own vehicle?*

    Is you're vehicle properly insured, and is the insurance renewed annually?*

    NOTE: You must have appropriate insurance cover for driving on our behalf, visiting our service users’ homes, and potentially taking service uses’ out in your vehicle. This is easily set up by contacting your insurance company. You must provide us with a copy of your insurance policy if you are offered employment with us.

    Have you ever been disqualified from driving, or been refused insurance?*
    Do you have any endorsements on this licence?*




    All offers of employment are subject to receipt of satisfactory references.

    If you have previously worked in domiciliary, nursing, or residential care before, you must include that employer in your list of Referees.

    If you are able to provide more than two references, we may be able to process your application more quickly.

    • Referee 1: - Your present or most recent employer
    • Referee 2: - Ideally from a previous employer. If this is not possible, then from professional member of the community (e.g. former colleague, tutor or teacher, GP, Solicitor or Accountant) who can comment on your ability and suitability to undertake the role of domiciliary carer. The reference cannot be a ‘friend’ or family relative. If you have worked in care before, but that care employer is not listed as Referee 1, you must list your most recent care employer as Referee 2.
    • Referee 3/4: - A character reference that can be from another person described in Referee 2, or alternatively a long-term family friend who is able to comment on your ability and suitability to undertake the role of domiciliary carer. For these two please provide details of their relationship to you.

    Note: Referres 3 and 4 will only be contacted if we cannot secure a reference from Referees 1 and 2.

    Reference 1

    Permission to contact reference?

    Reference 2

    Permission to contact reference?

    Reference 3

    Permission to contact reference?

    Reference 4

    Permission to contact reference?

    Working Time

    Our services are provided 7 days a week throughout the year. This includes early mornings, evenings and weekends and to fulfil your role you will need to be able to work regularly at some of these times. Please indicate below your availability in relation to working time.

    Will this be your only job?*

    Disclosure and Barring Service (DBS – formerly CRB) Check

    In the absence of an existing and current enhanced disclosure, your employment with Ashwell Home Care Services would be subject to satisfactory clearance following a Disclosure and Barring Service (DBS) search in respect of criminal convictions.

    All potential new employees must agree to the submission of a DBS application. The fee is paid by us on your behalf, although it is an express condition of your employment that we have the right to recover the fee directly from your final remuneration, if your employment is terminated (for any reason and whether by you or us), either during, or following the conclusion of, your probation period. An unfavourable response to a DBS application may result in the withdrawal of any offer of employment, or termination of employment if already commenced.

    If at any point during your ongoing employment with us, you become the subject of a criminal investigation; or you are cautioned or convicted of an offence, you are obliged to inform us of the details of the investigation, caution or conviction immediately. Furthermore, repeat disclosure searches in relation to all employees may be undertaken from time to time (usually annually).

    Ashwell Home Care Services is committed to the health and safety of all employees and every effort will be taken to minimise potential health risks to yourself and other workers. The information provided in the section below will remain confidential. Failure to disclose or the giving of false information could put yourself and others at risk.

    Please answer the following questions in the spaces provided. The information is purely for monitoring purposes, to assist applicants for arrangements for interview and to assess ability to do the duties intrinsic to the role. We do not discriminate against disabled applicants for any other purpose.

    Where did you here about our us?


    I declare that the information on this form is correct to the best of my knowledge.

    I have not withheld any information that could influence my application.

    I believe that I can effectively, diligently, and professionally fulfil the role and duties of a domiciliary carer.