Personal Assistant Application Form Submission


Title *: Mr.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Penarth
County *: 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. *: 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. *: In my last job (Sainsbury’s), I gained a lot of experience in physical work, this made me more active, I have quite an active lifestyle at the moment also. My mother is terminally ill and I have cared for her for 2 years, this has allowed me to fully understand care needs, be very prepared and supportive.
What qualities do you think are important when working as a personal assistant with a disabled person? *: I believe it’s very important to help people with disabilities to be as independent as possible, with lots of support. I believe they need to feel safe and well looked after at all times. Dignity is also a very important quality along with understanding and patience.
How do you think you can contribute towards the needs and the independence of a disabled person? *: I believe I can contribute lots of support emotionally and physically. My purpose would be to help with as many things as possible, make life and activities easier and more enjoyable.
What is it about PA work which appeals to you? *: I love building relationships and meeting with new people. I enjoy getting to know the interests of others. I believe it’s very rewarding helping others and their happiness contributes a lot to mine.
What are your hobbies/interests?: I really enjoy gaming, outings and any activities, I am very good with games, technical devices and handy work.
Would you consider a casual position if you are unsuccessful with this job? *: Yes
Do you drive? *: No
Are you a vehicle owner? *: No
Do you smoke? *: No
Are you able to undertake training? *: Yes
What days/nights are you able to work, or prefer to work? *: All apart from Thursday morning/ afternoon
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.:

In what capacity do you know this person (should not be a family member)? *: N/A managers have changed as this was a few years ago
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?: Penarth
How many hours of work can you offer per week?: Up to 35 hours a week
Please 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/Thursday Overnight/Friday AM/Friday PM/Friday Overnight/Saturday AM/Saturday PM/Saturday Overnight/Sunday AM/Sunday PM /Sunday Overnight/
Further Information: