HOMESHARER APPLICATION FORM

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PLEASE READ

TERMS & CONDITIONS

By completing and submitting this application form you are agreeing to our Homesharer Terms & Conditions.

REFERENCES

To Avoid delays processing your application we recommend that you have the contact details of two referees to hand in support of your application.

HOMESHARER PERSONAL INFORMATION

IMPORTANT INSTRUCTIONS

PLEASE COMPLETE *(Required) FIELDS AND CLICK SUBMIT AT THE END OF THIS FORM.

*ALTERNATIVELY, CLICK SAVE AND RESUME LATER.


PLEASE SELECT APPLICATION TYPE: (Required)

IMPORTANT INFORMATION:

1. HOMESHARER is Regular Homeshare Arrangement in which you provide between 10 to 15 hours of combined Companionship and General Support to a Household Homeshare Host each per week. With this arrangement you pay a fee of £190 per month which covers the cost of your Homeshare Arrangement.

2. HOMESHARER PLUS is an enhanced Homeshare Arrangement in which you provide between 20 to 25 hours of combined Companionship and General Support to a Householder Homeshare Host each week. With this arrangement YOU DO NOT PAY any monthly fees and in addition to provision of accommodation and cost of utility bill covered (fair usage policy applies), you are also given a reasonable allowance to cover your weekly/monthly food costs.
FULL NAME (Required)
GENDER (Required)
DATE OF BIRTH (Required)
ADDRESS (Required)
INFORMATION: Address Auto-Lookup and Auto Complete is available in this section.
Click or drag a file to this area to upload.
Please Provide ONE Recent Photograph of Yourself for Internal Identification Purposes.

THE PICTURE MUST NOT BE MORE THAN 10MB IN SIZE AND BE IN EITHER ONE OF THE FOLLOWING FORMATS:

PNG
GIF
JPEG
TIFF
RAW
PSD

HOMESHARER HEALTH & WELLBEING DISCLOSURE

IMPORTANT INFORMATION - PLEASE READ CAREFULLY

Please tell us about any health and wellbeing conditions.
HOMESHARER HEALTH & WELLBEING DISCLOSURE (Required)

IMPORTANT INFORMATION


As part of the Supportmatch Homeshare Arrangement, it is essential to confirm that you are fully capable of providing the necessary companionship and practical support to the Householder you may be matched with.

Please select one of the following options, to either confirm that you do not suffer from any physical or mental health conditions that would impede your ability to fulfil these responsibilities effectively, or that you would like to disclose a health and wellbeing condition.

EMERGENCY CONTACT OR NEXT OF KIN (NOK)

We Recommend that Homesharers provide an Emergency Contact.
NOK Full Address (Required)
NOK Relationship to Homesharer (Required)

 

 

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