Personal Assistant Application Form Submission

Title *: Mrs.

First Name *:


Address 1 *: 

Address 2: Brynna

Town *: Pontyclun

County *: R.C.T

Postcode *: 

Phone number *: 

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

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 have gained a lot of experience and relevant training including NVQ Level 3 in Care. Providing person centered care for individuals. Supporting and enabling people to live the life they choose. To support individuals and encourage them to make choices, to express themselves, live as independently as possible. Promote self help and daily living. I have worked within the care sector for many years. Working in a variety of settings including domiciliary care, Specialist Support worker (Assisted living), care homes, Personal Assistant within peoples homes, Education (Additional Learning Needs) Nursing Assistant in a residential hospital for individuals with learning disabilities. I have worked with a variety of people ie. Multi Sensory Impairment, Moderate Learning Difficulties, Profound and moderate Learning Difficulties, Severe Learning Difficulties, Emotional Behavioral Difficulties, Elderly, Physically Disabled, TRAINING... 2003 NVQ in Care Level 3 2004-2015 Word Processing OCN Level 1&2 Computers OCN level 1 Counselling OCN Level 1 Working with Primary School Children OCN Level 2 2019 Manual Handling All Wales Passport, Emergency First Aid & Buccal, Diabetes Awareness, Food safety, Sensory Awareness level 2, e Nutrition Awareness, e Allergen Awareness, e Asthma Awareness, e Autism Awareness, e Confidentiality & Data Protection, e Coshh, e Dementia Awareness, e Diabetes Awareness, e Dignity & Privacy, Epilepsy Awareness, e Equality, Diversity & Inclusion, e Infection Control, e Manual Handling of objects, e Maybo , e Medication Awareness, e Safeguarding Awareness. 2018 All Wales Manual Handling Passport, Infection Control, Manual Handling, Dysphasia Refresher, Safeguarding, Health & safety, Providing Personal Care, Defibrillator & CPR. 2001-2016 Infection Control, Student Communication Passports, Assistive Technology Positive Behavior Management, Violence and Aggression 1998 Sign Along, Assessing Communication Better Epilepsy, Social Role valorization Mental Health, Additional Learning Needs children, ADHD, Autism,

What qualities do you think are important when working as a personal assistant with a disabled person? *: Be responsible and reliable, understanding the challenges that face disabled people, flexible to the individual you support, understanding and showing empathy, be encouraging and supportive, Being respectful if working in someones home and have the ability to treat people with dignity. Be a good listener if someone is having a bad day. Being professional at all times and being able to take instruction from the person you are supporting.

How do you think you can contribute towards the needs and the independence of a disabled person? *: Providing a person centred approach as everyone is different. Being encouraging and supportive when needed but not taking over. Help to build upon or gain new skills. My training and skill set along with with experience has helped me adapt to any given situation and to adapt to the individual I support.

What is it about PA work which appeals to you? *: Being a PA is varied and no 2 days are the same. It gives me great satisfaction to see someone achieve something that they thought they couldnt without support. Given them a can do attitude and self empowerment along with achievement.

What are your hobbies/interests?: I enjoy cooking, walking, watching factual tv shows and documentaries, computers, diy.

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? *: Any days. Prefer to work


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 *: 

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

Name *: 

Job Title *: 

Address *:

 01443 442300

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

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?: R.C.T

How many hours of work can you offer per week?: Any

Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Tuesday AM/Tuesday PM/Wednesday AM/Wednesday PM/Thursday AM/Thursday PM/Friday AM/Friday PM/
Further Information: Available for work any days and times between Monday-Friday