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Click ‘Get Form’ to open the home care aide registration application in the editor.
Begin by entering your full legal name in the designated fields. Ensure you do not use nicknames, and it’s advisable to match the name on your ID.
List all other names you have ever used, including any aliases. This ensures clarity and accuracy in your application.
Fill in your complete residence address. Remember to spell out city names fully, as abbreviations will not be accepted.
If your mailing address differs from your residence, provide that information next. It’s crucial for future correspondence.
Enter your email address if you wish; this is voluntary but can facilitate communication regarding your application.
Input your date of birth in MM/DD/YY format. Ensure you are at least 18 years old to qualify for registration.
Indicate your sex by entering 'M' for male or 'F' for female.
Provide your Social Security Number. While this is voluntary, omitting it may delay processing.
Enter a valid ID number from one of the accepted forms: California Driver’s License, ID card, Alien Registration Card, or another state-issued picture ID.
Finally, list both daytime and evening telephone numbers for contact purposes and ensure you sign and date the application before submission.
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