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Personal Assistant Application Form Submission

Title *: Ms.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: R. C. T
County *: R. C. T
Postcode *:
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. *: Hi Im Jane I have 17 years experience in the care sector. I have used hoists and worked in a residential care home and a nursing home. I have a vast list of training I have undertaken over the years. I am currently living in mountain Ash but I will be moving to Aberdare in the next couple of weeks pending mortgage finalization. I have a level 3 diploma in health and social care and with my many years of experience you could say I am a fully fledged wheelchair driver!
What qualities do you think are important when working as a personal assistant with a disabled person? *: - Patience - Kindness - Compassionate - Understanding - Emotionally in tune - A sense of humour - Capable - Confident - Approachable - Enthusiastic - Flexable
How do you think you can contribute towards the needs and the independence of a disabled person? *: I can easily and confidently care for a person with disabilities. I can care for her physically emotionally. I can safeguard and protect her. I am confident at working with and communicating with people of all professions in order to meet her needs. I would like to increase her interests and help empower her to have confidence in me and herself. I am a naturally kind and descrete person who takes confidentiality and dignity very seriously. I have a bubbly sense of humour but I know when to be serious.
What is it about PA work which appeals to you? *: The one to one support would be so rewarding for me. I can give them to time and support they require. I like making people feel safe and happy. I want them to feel free to be able to tell me how they are feeling. I would like to build a rapport and professional relationship with them and make them feel relaxed whilst they are with me.
What are your hobbies/interests?: - Socializing - Travelling - Swimming - Music - Swimming - Country walks I love nature!
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? *: Any day or night beside Wednesday night and Sundays
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.: Please note I will be moving close by in Aberdare in a couple of weeks time so it will be easy for me to travel back and foe to work
Name *:
Job Title *:
Address *:
Phone Number *:
In what capacity do you know this person (should not be a family member)? *:
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?: Aberdare
How many hours of work can you offer per week?: 30
Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Tuesday AM/Tuesday PM/Wednesday AM/Thursday AM/Thursday PM/Friday AM/Friday PM/Saturday AM/Saturday PM/
Further Information: