Personal Assistant Application Form Submission Title: Mrs Town (required): Hengoed Give details of your previous employment or experience which you think would help you to do this job. (required): I have worked with several clients over the last 4 years with varying degrees of disabilities. Primarily my clients have had cerebral palsy but I have also worked with a person with a muscle wasting disease and others with dementia . What qualities do you think are important when working as a personal assistant with a disabled person? (required): Patience , kindness , respect . Treating them as an equal and always doing your very best to ensure their needs are met. How do you think you can contribute towards the needs and the independence of a disabled person? (required): I would hope to be able to facilitate any activity the person would like to take part in whether this be an act of leisure , medical appointment or simple shopping trip . I would treat them with respect and dignity and help them live as independent a life as is possible , always respecting their wishes . What is it about PA work which appeals to you? (required): Flexible hours that arent the usual 9 til 5 The knowledge that you are making a persons life easier and enabling them to live a full life that may not be able to without your help What are your hobbies/interests?: Interior design and animal welfare Would you consider a casual position if you are unsuccessful with this job? (required): Yes Do you speak any other languages? (required): No Do you drive? (required): Yes Are you a vehicle owner? (required): Yes Do you smoke? (required): No Are you able to undertake training? (required): Yes What days/nights are you able to work, or prefer to work? (required): Monday, Tuesday,Wednesday ,Friday,Sunday some days can be full others partial Are there any circumstances which would prevent you from providing cover or swapping a shift? (required): Yes If you would like to expand on the answers given above? Please use the box below.: I work 2 x 24 hour shifts on a Thursday and Saturday Do you have portable DBS (which has been paid for and renewed for the current year)? (required): Yes/ Is there is any such information you wish to disclose, relating to any cautions or convictions which will appear on your mandatory DBS check? (required): No/ Please provide details if necessary: I agree that there is nothing which would prevent me from doing this job. (required): Yes I consent to the above (required): Yes I agree that the information I provide will be posted to the Dewis CIL PA noticeboard (all personal information will be withheld).: Yes What geographical area’s are you able to cover?: Cardiff and The Vale How many hours of work can you offer per week? (required): 20 Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Tuesday AM/Wednesday AM/Wednesday PM/Friday PM/Sunday PM /Sunday Overnight/