Personal Assistant Application Form Submission

Title *: Miss

First Name *: 

Last Name *: 

Address 1 *:

Address 2:

Town *: Ferndale

County *: Rct

Postcode *:

Phone number

Please enter your email address for submission confirmation. *:

Reference number of job being applied for *: DP1538

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 with children with ASD and have worked many years with both adult and children with complex need. I have have previously worked for Dewis being a PA to a older gentleman providing personal care and sleep in at their own home. I have many year experience working in the care sector in the community and in a nursing home environment.

What qualities do you think are important when working as a personal assistant with a disabled person? *: Respect the persons dignity. Be kind. Treat with respect . Patients .             
How do you think you can contribute towards the needs and the independence of a disabled person? *: help you with your daily tasks , ensure ur safe and happy.     
What is it about PA work which appeals to you? *: Sound like a fun and person to be around that think we would get on well with some interests the same.       
What are your hobbies/interests?: Shopping , music , crafts , cinema , spending time with my son , outdoor person and playing with new gadgets.
Would you consider a casual position if you are unsuccessful with this job? *: No         
Do you drive? *: Yes            
Are you a vehicle owner? *: Yes
Do you smoke? *: No
Are you able to undertake training? *: No
What days/nights are you able to work, or prefer to work? *: Tuesay 8-2, , Wednesday 8-3 , Thursday 8-2 ,
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.:
Name *:
Job Title *: Address *:
Phone Number *: N/A
In what capacity do you know this person (should not be a family member)? *: Work
Name *:
Job Title *: Address *:
Phone Number
In what capacity do you know this person (should not be a family member)? *: Work
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. *: No
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?: Rhondda 10miles
How many hours of work can you offer per week?: 18-20
Please indicate the approximate times that you are available for work throughout the week.: Monday PM/Monday Overnight/Tuesday AM/Tuesday PM/Tuesday Overnight/Wednesday AM/Thursday AM/Thursday PM/Thursday Overnight/Friday PM/Friday Overnight/
Further Information: