Personal Assistant Application Form Submission

Title *: Mrs.
First Name *:
Last Name *:
Address 1 *:
Address 2: Flemingston
Town *: Barry
County *: Vale of Glamorgan
Postcode *: CF62  
Phone number *:
Please enter your email address for submission confirmation. *:
Reference number of job being applied for *:
I confirm that I have the right to work in the UK and am able to prove my eligibility status when required to do so. *: Yes
Please read the Job Description carefully before providing information in this Section of the Application Form. Give details of your previous employment or experience which you think would help you to do this job. *: 3previous Dewis clients
What qualities do you think are important when working as a personal assistant with a disabled person? *: Common sense. Discretion. Ability to listen to what is required.
How do you think you can contribute towards the needs and the independence of a disabled person? *: By supporting clients wishes and knowing when to support and when to step back
What is it about PA work which appeals to you? *: I enjoy getting to know a person and enabling them to be as independent as possible
What are your hobbies/interests?: Walking. Riding horses. Reading.
Would you consider a casual position if you are unsuccessful with this job? *: Yes
Do you drive? *: Yes
Are you a vehicle owner? *: Yes
Do you smoke? *: No
Are you able to undertake training? *: Yes
What days/nights are you able to work, or prefer to work? *: Any weekday. Not weekends in general
Are there any circumstances which would prevent you from providing cover or swapping a shift? *: No
If you would like to expand on the answers given above? Please use the box below.: My recent Dewis job has ended due to client passing. Able to be quite flexible with hours given notice

In what capacity do you know this person (should not be a family member)? *: Last Dewis employment
Is there is any such information you wish to disclose, relating to any cautions or convictions which will appear on your mandatory DBS check? *: No/
Please provide details if necessary:
I agree that there is nothing which would prevent me from doing this job. *: Yes
I consent to the above *: 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?: Barry Rhoose St Athan Llantwit. Most of Vale of Glamorgan
How many hours of work can you offer per week?: 12
Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Tuesday AM/Tuesday PM/Wednesday AM/Wednesday PM/Thursday AM/Thursday PM/Friday AM/Friday PM/
Further Information: