Personal Assistant Application Form Submission


Title *: Miss.


First Name *: Nicola


Last Name *: Phillips


Address 1 *:

Address 2:


Town *:
County *: RCT


Postcode *:


Phone number *:


Please enter your email address for submission confirmation. *:


Reference number of job being applied for *: DP1536


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 current work with my sister who has Down syndrome. Within the job role with my sister I am required to encourage her independence into the community by taking her shopping, cinemas, contents, dog walking in the park etc. To encourage my sister into the community I use my own vehicle to transport myself and Donna around. Experience:- When a family member was thermally Ill. I supported this person throughout, washing, Bathroom, dressing, cleaning etc. When managing these types of roles its important to remember their dignity and being compassionate as their needs become different.


What qualities do you think are important when working as a personal assistant with a disabled person? *: Patience understanding compassionate confidentiality good communication skills encouraging/positive attitude motivated Respectful Honest reliable


How do you think you can contribute towards the needs and the independence of a disabled person? *: From my experiences within this line of work its given me the confidence and skills to ensure that all clients needs are fully meet to their expectations.


What is it about PA work which appeals to you? *: I like to think Im helping someone feel good about their self again. By gaining their confidence back to engage into their community and daily living.


What are your hobbies/interests?: cleaning shopping family time walking cooking


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? *: Monday - Friday (Hours are flexibable)


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.:
Name *:
Job Title *:
Address *:
Phone Number *:
In what capacity do you know this person (should not be a family member)? *:


Name *:


Job Title *: r


Address *:


Phone Number
In what capacity do you know this person (should not be a family member)? *:

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?: RCT area


How many hours of work can you offer per week?: monday - friday (25 hours)
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/Wednesday Overnight/Thursday AM/Thursday PM/Friday AM/Friday PM/Friday Overnight/
Further Information: