Personal Assistant Application Form Submission


Title *: Miss.
First Name *:  
Last Name *:
Address 1 *: 
Address 2:
Town *: Pontypridd
County *: RCT
Postcode *: CF38 
Phone number *: 
Please enter your email address for submission confirmation. *: 


Reference number of job being applied for *: DP1583


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. *: I currently work in supported living with adults with learning disabilities. I support a lady who suffers from severe epilepsy. I work part time, I am a driver and have business insurance. I also do 3 hours a week PA with a 9 year old boy whose autistic. I support him swimming, cinema , jump jam , to the beach .


What qualities do you think are important when working as a personal assistant with a disabled person? *: I am very patient, friendly, good listener. And I value everyone’s own choices.


How do you think you can contribute towards the needs and the independence of a disabled person? *: I am a happy person who likes to socialise , and I feel I help the people I support to enjoy their activities and one to one time.


What is it about PA work which appeals to you? *: I like helping others and spending time with others.


What are your hobbies/interests?: Swimming , cinema , bowling , shopping , cleaning


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
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.:


If there is any such information you wish to provide? *: Yes
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?: Rhondda Cynon Taff
How many hours of work can you offer per week?: 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/Saturday AM/Saturday PM/Sunday AM/Sunday PM /
Further Information: