HEALTHCARE ASSISTANT APPLICATION FORM

    (EU / EEA Citizens Only)
    Please complete all sections carefully and honestly.
    Healthcare roles in Ireland require strict safeguarding procedures, compliance checks, Garda Vetting, and background screening.
    Providing false, misleading, or incomplete information may result in delays, disqualification, or withdrawal of employment opportunities.

    SECTION 1 – PERSONAL DETAILS

    1. Full Name (Required)
    Please enter your full legal name exactly as shown on your passport or national ID.
    2. Nationality
    A. Select from list
    B. Manual entry (required)
    Please specify your nationality
    3. Current Country of Residence
    A. Select Country
    B. Manual entry (required)
    Please specify your current city and country of residence
    4. Passport or National ID Held
    A. Select Issuing Country
    B. Manual entry (required)
    Please confirm which country issued your passport or national ID
    5. Contact Information
    Email Address (Required)
    WhatsApp Number (Required)

    SECTION 2 – ROLE APPLICATION

    6. Position Applying For
    Checkbox (Select all that apply)
    HEALTHCARE ROLES
    Manual Entry Required: Please specify your preferred healthcare role.
    7. Preferred Work Location in Ireland
    Checkbox (Select all that apply)
    Manual Entry Required: Please specify preferred counties or regions if applicable.
    8. Type of Work Seeking
    Checkbox (Select all that apply)
    Manual Entry Required: Please clarify your preferred work type.

    SECTION 3 – QUALIFICATIONS & EXPERIENCE

    9. Healthcare Qualification Held
    Dropdown Selection
    IMPORTANT: Most Healthcare Assistant roles in Ireland require QQI Level 5 Healthcare Support qualification or a recognised EU equivalent qualification. If your qualification was completed outside Ireland, additional documentation or equivalency review may be required during the recruitment process.
    Manual Entry Required: Please specify Qualification name, Country obtained, School / Institution, Year completed.
    10. QQI Recognition Awareness
    I understand that Healthcare Assistant roles in Ireland may require QQI Level 5 Healthcare Support qualification (or recognised equivalent) and that additional documentation may be requested during the recruitment process.
    11. Years of Healthcare Experience
    Dropdown
    Manual Entry Required: Please briefly summarise your healthcare experience.
    12. Main Healthcare Environment Experience
    Checkbox (Select all that apply)
    Manual Entry Required: Please describe your strongest healthcare experience.
    13. Experience Supporting Elderly Residents
    Dropdown
    Manual Entry Required: Please explain your experience supporting elderly residents or vulnerable adults.

    SECTION 4 – LANGUAGE & COMMUNICATION

    14. English Language Level
    Dropdown
    Manual Entry Required: Please describe your ability to communicate in English within a healthcare environment.
    15. Resident Care & Teamwork Readiness
    Are you comfortable with personal care duties, assisting residents with mobility, working as part of a nursing team, supporting residents living with dementia?
    Manual Entry Required: Please briefly confirm your experience in these areas.

    SECTION 5 – AVAILABILITY & FLEXIBILITY

    16. Earliest Availability to Relocate
    Dropdown
    Manual Entry Required: Please confirm your relocation availability.
    17. Shift Flexibility
    Are you willing to work: (Select all that apply)
    Manual Entry Required: Please confirm your flexibility.
    18. Accommodation Support
    Do you require accommodation support in Ireland?
    Manual Entry Required: Please briefly explain your accommodation situation.

    SECTION 6 – GARDA VETTING & COMPLIANCE

    IMPORTANT NOTICE
    All healthcare workers in Ireland must successfully pass Garda Vetting procedures before employment can commence. Healthcare employers are legally required to protect vulnerable adults and maintain safeguarding standards.
    Failure to disclose important legal, safeguarding, or employment information may negatively affect your application or Garda Vetting outcome.
    19. Garda Vetting Awareness
    I understand that Garda Vetting is mandatory for healthcare roles in Ireland.
    20. Legal & Background Declaration
    Have you EVER had criminal convictions, ongoing legal investigations, safeguarding concerns, dismissal from healthcare employment, abuse or misconduct allegations, or serious workplace disciplinary issues?
    IMPORTANT: Failure to declare relevant legal or employment issues may result in failed Garda Vetting clearance or withdrawal of employment opportunities.
    Manual Entry Required (if Yes): Please provide honest and accurate details.
    21. Previous Visa / Immigration Issues
    Have you ever experienced visa refusal, deportation, immigration ban, or removal from employment abroad?
    Manual Entry Required (if Yes): Please provide details if applicable.
    22. Employment Accuracy Confirmation
    I confirm that all information provided in my CV, application, and supporting documents is accurate and truthful.

    SECTION 7 – POLICE CLEARANCE REQUIREMENTS

    IMPORTANT NOTICE
    Healthcare employers in Ireland may require Police Clearance Certificates / Certificates of Good Conduct as part of the recruitment and safeguarding process.
    Candidates may be required to provide police clearance documentation from: Their country of nationality, Their current country of residence, Any country where they have lived or worked for more than 6 months.
    Failure to provide required police clearance documentation may delay or prevent progression of the application.
    23. Police Clearance Awareness
    I understand that Police Clearance Certificates may be required from all countries where I have lived or worked for more than 6 months.
    24. Countries Previously Lived or Worked In
    Manual Entry Required: Please list all countries where you have lived or worked for more than 6 months (include approximate dates). Example: Italy – 2022–2024.
    25. Police Clearance Availability
    Can you obtain Police Clearance / Certificate of Good Conduct documents if requested?
    26. Previous Legal or Safeguarding Concerns
    Do you have any previous legal, safeguarding, abuse, violence, or misconduct concerns that could negatively affect police clearance checks or employment within the healthcare sector?
    IMPORTANT: Healthcare roles involve working with vulnerable adults. Any safeguarding concerns, violent offences, abuse-related matters, or undisclosed legal issues may negatively affect recruitment or Garda Vetting outcomes.
    Manual Entry Required (if Yes): Please provide honest and accurate details.

    SECTION 8 – REFERENCES & DOCUMENTS

    27. Employment References
    Can you provide two Employment References (including one from your most recent employer)?
    Manual Entry Required: Please provide one reference contact if available.
    28. Required Documents Available
    Please confirm you can provide:

    SECTION 9 – FINAL DECLARATION

    29. Minimum Commitment
    How long do you realistically plan to remain working in Ireland?
    30. Interview Availability
    Are you available for interview via WhatsApp Video, Zoom, or Microsoft Teams?
    31. Final Candidate Declaration
    I confirm that all information provided is truthful and understand that false or misleading information may result in withdrawal of employment opportunities or termination of the recruitment process.
    Signature Confirmation
    Manual Entry Required: Please type your full name as confirmation.

    SECTION 10 – HEALTH & WORK CAPABILITY DECLARATION

    EU WorkForce is committed to placing candidates into roles where they can perform safely and effectively.
    Do you have any condition or require any workplace adjustments that may impact your ability to carry out the essential duties of the role?
    NoYes (please provide details below)
    Manual Entry: Details (if applicable)
    All information provided will be treated confidentially and used only to assess suitability for healthcare roles and any required workplace support.

    SECTION 11 – PRIVACY & DATA PROTECTION

    I have read and agree to the Privacy Policy. I understand that my personal data will be processed for recruitment and employment purposes by EU WorkForce.