101VOG Personal Assistant Application Form Submission Title *: Miss.First Name *: Last Name *: Address 1 *: Address 2: Garden SuburbTown *: BarryCounty *: Vale of GlamorganPostcode *: 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. *: YesPlease 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. *: I have always worked with people over the years, retail and education in comprehensive schools. I have a broad knowledge of travel, books and a great sense of humour. I get along with people in general, I have a pleasant approach with a professional attitude. I care for family and friends. What qualities do you think are important when working as a personal assistant with a disabled person? *: To understand their needs firstly. Listen and understand whats important to that person. Be a great listener, have a good sense of communication at all times. Enjoy to assist them to make their life easier and enjoyable. How do you think you can contribute towards the needs and the independence of a disabled person? *: Talk, communicate, I am a very happy person, so I hope I could bring confidence and safety to the person. What is it about PA work which appeals to you? *: Assisting a person in need primarily. Bring some confidence and joy from what I have achieved in life! Share experiences by communication. And making sure the person feels safe.What are your hobbies/interests?: Reading, travelling in the past! Walking, cooking, doing hanging baskets. Family time and cooking lots!Would you consider a casual position if you are unsuccessful with this job? *: YesDo you drive? *: YesAre you a vehicle owner? *: YesDo you smoke? *: NoAre you able to undertake training? *: YesWhat days/nights are you able to work, or prefer to work? *: AnyAre there any circumstances which would prevent you from providing cover or swapping a shift? *: NoIf you would like to expand on the answers given above? Please use the box below.: 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. *: NoI consent to the above *: YesI agree that the information I provide will be posted to the Dewis CIL PA noticeboard (all personal information will be withheld).: YesWhat geographical area’s are you able to cover?: BarryVOGHow many hours of work can you offer per week?: 16-20Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Monday Overnight/Tuesday AM/Tuesday PM/Tuesday Overnight/Wednesday AM/Wednesday PM/Wednesday Overnight/Thursday AM/Thursday PM/Thursday Overnight/Friday AM/Friday PM/Friday Overnight/Saturday AM/Saturday PM/Saturday Overnight/Sunday AM/Sunday PM /Sunday Overnight/Further Information: