homecare assistant application：家庭护理助理的应用.docx

homecareassistantapplication：家庭护理助理的应用MyHomecare.ieReV02HomecareAssistantApplicationThankyouforyourenquiryaboutworkingwithMyHomecare.ie/SerViSoUrCeHealthCareMyhomecare.ieincorporatingpartofServisourceHealthcareplaceHomecareAssistantswithclientsandthroughoutIreland,cover!nglong-term,mediUniandshort-termpositions.Ourcompany'spo1icyiStoprovideaconsiStentandqualityservicebVmatchingtheindividua1needsofbothorCareStaffandourClients.Ourofficeisopen7daysaweekfrom7amtol1pm,363daysoftKeyeartoprovidethebestpossibleservice.PleasefillIntherelevantdetaiIsintheapplIcationpackandsenditbacktouswithasmuchinformatiOnasyoucanprovideiminediate1y.AchecklistOfrequirementsisonthefolIowingpagetoassistyou.Pleasebeawarethatallreferencesandqualificationswillbechecked.PleaseSignanddatetheapplicatIonandreturnittoourofficesat:ServisourceOffices:DundalkOfficeUnit3,Floor2,QuaysideBusinessCentre,Dundalk,Co1.outhTel:+353429352723Fax:+353429352724GalwayOffice16aSandyfortBusinessCentre,Bohermore,GalwayTel:+35391762426/761051Fax:+35391762429CorkOffice11AngleseaStreet,CorkTel:+353214279916/4279739Fax:+35391427991DublinOfficeInternationalHouse,TaraStreet,Dublin2Tel:Ol4730474Fax:Ol6334269WaterfordOfficeWaterfordHealthPark,SlievekealeRoad,CoWaterfordTel:1800400900ContactDetaiIsServisourceRecruitmentTeamEmai1:infoervisource,iePleasealsocheckoutourwebsite:pletedwithininthelast2year8ModulesHomecareAssislantApplicationHowhearaboutourAgency?didyouNewspaperNursingMagazinesInternetFriendsOtherPersonalDetailsFirstName:ATTACHSIGNEDPASSPORTPHOTOSSurname:PreviousName:ddressMobiIeNo.HomeNo.WorkNo.EmailAddressGenderDateoCBirthPPSNumberNextofKinContactDetaiIsforNextofKinDoyouholdaGardaNationalImmigrationBureaucard?YesNoIfYespleasestatestampnumberandexpirydatePreferredHealthcareIocationsyouwishtoworkinHomecareAssistantApplicationTrainingEducationAreyouaStudentNurse?YesNoWhatdisciplineareyoustudying?IfYes,NameofTrainingHospitalPleasenotethatstudentNursesareexeniptfromFETACrequirements.FETACHaveyouconipletedorareyouinIheprocessofcompletingaFETCHealthcareSupportMajorAward?YesNoFETClevel5MajorAwardinHcaltHcarcSupportiscomposIedof8modu1cs.OutoftheseSmodules,5aremandatoryand3areeIective.PIeaseindiCatethemodu1esyouhavecomp1OtedandcncIosedcertifications:MandatoryModules:CareSkillsCareSupportSafetyHealthatWorkElectiveModules:NutritionPractIcalHomecareSkillsCareoftheIderPersonOccupationalFirstAidPalliativeCareCareProvisiOnandPracticeAnatomyandPhysiologyChildDevelopinentHumanGrowIhandDeve1opmentWordProcessingIntroductiontoNursingCustomerServiceCaringforChi1dren(06years)MaternItyCareSupportOperatingDeparUnentCareSki11sIntellectualDisabil1.tyStudiesCommunicationsWorkExperienceCaringforChi1dreninllospitalRehabilitationSupportUnderstandingMentalHealthSocialStudiesPersonalEffectivesintheWorkplaceTeamworkingHaemodialysiSCareSupportActiviticsof1.ivingPationtCareWorkp1aceStatutoryPo1iciesandProceduresTnfectiOnPreventionandContro1WorkplaceFoodSafetyandHygieneFoodSafetyHACCPOtherHomecareAssistantApplicationEmploymentHistoryRcferenccsWerequirenamesandcontactdetailsofyour3refereesfromyourcurrentandmostrecentemployment.RefereesmustbeofManagement1.evelorHigherOnereferencemustbefromyourcurrentormostrecentemployerAnyoffersofapostissubjecttosatisfactoryreferencesCurren11MostReccntEmp1oy11tmtOrganisationPositionHeldDateTo:From:MonthsinPost(1st)Referee,sNameFromCurrentPositionorMostRecentEmploymentReferee'sPositionRefereesContactDetaiIsPhone/FaxIEmailHomecareAssistantAppicationPreviousEmp1oyment:OrganisationPositionHeldDateMonthsinPostTo:From:(2nd)Referee,SNameReferee,SPositionRefereesContactDetailsPhone/FaxIEmailOrganisationPositionHeldDateTo:From:(3rd)Referee,SNameReferee,SPositionRefereesContactDetailsPhone/FaxIEmailPleasecontinueyourexperienceandemploymentonseparateCurriculumVitaeHomccareAssistantApplicationPersonalPayDetai1sPleasefillinthefolIowinginformationcarefullyandreturnitwithyourapplicationformFirstNameSurnameAddressMobiIePhoneNumberHomePhoneNumberEmailAddressDateofBirthStaffTypeHomecareAssistantBankIBANCodc:BankSWIFTCode:AccountNumber(8numbers)BankSortCode(6numbers)BankNameAddressPPSNumberHomecareAssistantpp1icationHomecareAssistant,sPleasestatecoursetitleanddurationofcourseorexperienceExperienceCourseTitleDurationCompetentlevel(1-5)AccidentEmergencyCareofElderlyClinicsComputersDrugsAlcoholHomecareInfectiousDiseasesMedicalMidwiferyPaediatricsPalativeCarePsychiatrySurgicalTheatres/RecoveryOthersSign：Date:一HoniecareAssistantApplicationHealthDeclarationIdeclarethatIunderstand,acceptandconfirmtheentitlementofMyHomccaretorejectmyapplicationorterminatemyemployment(intheeventofacontractofemploymenthavingbeenenteredinto)whereIhaveomittedtofurnishtheAgencywithanyinformationrelevanttothishealthassessmentorwhereIhavemadeanyfalsestatementormisrepresentationrelevanttothishealthassessment.PleaseanswerYESorNOandifYES,pleasegivedetailsinthespaceprovided.YesNoDetails1