Personal Assistant Application Form Submission

Title *: Miss.

First Name *: 

Last Name *: 


Address 1 *: Address 2: Treharris

Town *: Treharris

County *: Merthyr Vale


Postcode *: 

Phone number *:

Please enter your email address for submission confirmation. *: Reference number of job being applied for *: DP1549

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 currently work as a home care worker within the community, I feel I have gained the experience for washing, dressing and using person centred approach when working. I enjoy helping people and like the sound of this role.

What qualities do you think are important when working as a personal assistant with a disabled person? *: To work in a person centred approach. To get to know the persons likes (and dislikes) To offer choices Establish a rapport To ensure needs are met with regards to meals, washing, dressing, medication etc.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I have worked in a respite with children with learning difficulties for 8 years, I now support the elderly within their own homes as a home carer. I feel I have enough experience for this role and hope that I would be successful.

What is it about PA work which appeals to you? *: I enjoy helping people, I live in Treharris, therefore I am in the local area. I currently work for Support @ Home which is a Home carer role, however, I feel it would be more rewarding to work 1:1 with someone as you would build a better relationship.

What are your hobbies/interests?: I enjoy keeping fit, I like yoga and swimming and going to the gym. I also enjoy watching films and going out for meals. I enjoy nice walks along the beach, I love going to Swansea and West Wales in any weather.

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? *: Days

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 am currently employed by RCT, if I was successful for this job, I would hope to keep both jobs on a casual basis. RCT rota is only one week in advance, however, I would aim to work around both jobs.
Name *: 

Job Title *: 


Address *: TPhone Number *: In what capacity do you know this person (should not be a family member)? *: I have worked for RCT since January 2019, however, Lisa has only been my line manager since July 2019

Name *: 

Job Title *: 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? *: 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?: Merthyr and RCT

How many hours of work can you offer per week?: 0-20

Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Tuesday AM/Wednesday AM/Thursday AM/Friday AM/
Further Information: I am currently employed by RCT as a home carer, I am hoping to keep both of these jobs positions if I were to be successful.