109VOG Personal Assistant Application Form Submission Title *: Miss.First Name *: Last Name *: Address 1 *:Address 2: Town *: Dinas PowysCounty *: Vale of Glamorgan Postcode *: CF64 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 haven’t actually worked in care work before, but I consider myself to be a caring, patient individual and I know care work would be something I would really enjoy. What qualities do you think are important when working as a personal assistant with a disabled person? *: I think you would need to be kind, friendly and compassionate, somebody who has patience and a natural caring nature. How do you think you can contribute towards the needs and the independence of a disabled person? *: I think I could bring happiness to them giving them help with whatever their needs would be, but not to be patronising whist doing so. Letting them know that nothing they ask for would be too much trouble. Making sure they can feel comfortable with you by being as friendly and caring as possible. What is it about PA work which appeals to you? *: I believe it would be a very fulfilling and rewarding job. Knowing you’re really making a difference to somebody’s life really appeals to me. What are your hobbies/interests?: I enjoy going for walks with my dog, spending time with my family and watching movies and listening to music. I also enjoy gardening and cooking. Would you consider a casual position if you are unsuccessful with this job? *: YesDo you drive? *: NoAre you a vehicle owner? *: NoDo you smoke? *: YesAre you able to undertake training? *: YesWhat days/nights are you able to work, or prefer to work? *: Any up to 16 hours. Are 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. *: YesI 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?: Dinas Powys. Penarth. Sully. Barry. How many hours of work can you offer per week?: 16Please 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/Saturday AM/Saturday PM/Sunday AM/Sunday PM /Further Information: