Personal Assistant Application Form Submission

Title *: Ms.
First Name *: 
Last Name *:
Address 1 *: 
Address 2: Cwmgwrach,
Town *: Neath
County *: NPT
Postcode *: SA11
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. *: I am an experienced ALN teaching assistant, I teach Art & Design in a mainstream school and support a wide variety of learners with different learning needs every morning.


What qualities do you think are important when working as a personal assistant with a disabled person? *: Patience, respect and a sense of humour. Good time keeping and a consistent, friendly approach.


How do you think you can contribute towards the needs and the independence of a disabled person? *: Through listening to the persons opinions and preferences and by maintaining dignity and respect.


What is it about PA work which appeals to you? *: I like community based work and meeting new people.


What are your hobbies/interests?: I enjoy going to my local library, cooking, walking my dog and spending time with my family.


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? *: Evenings and/or weekends as I work in a local primary school [I finish at 3.30] I am available for additional hours during school holidays.


Are there any circumstances which would prevent you from providing cover or swapping a shift? *: Yes


If you would like to expand on the answers given above? Please use the box below.: I would not be able to swap a shift for daytime hours.


If there is any such information you wish to provide? *: No


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?: Aberdare, Merthyr, Glynneath


How many hours of work can you offer per week?: Ideally 8-12


Please indicate the approximate times that you are available for work throughout the week.: Monday PM/Tuesday PM/Wednesday PM/Thursday PM/Friday PM/Saturday AM/Sunday AM/