142VOG Personal Assistant Application Form Submission Title (required): First Name (required): Last Name (required): Address 1 (required): Address 2: Town (required): BarryCounty (required): Vale Of GlamorganPostcode (required): Phone number (required):Please enter your email address for submission confirmation. (required): Reference number of job being applied for (required): 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. (required): YesPlease 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. (required): I have worked for two care agencies before becoming a P.A for these past 12 years.What qualities do you think are important when working as a personal assistant with a disabled person? (required): I am very trustworthy, Sincere and try always to promote independence with the service users Ive assisted in the past. How do you think you can contribute towards the needs and the independence of a disabled person? (required): Firstly by listening to their instructions, Secondly carrying out their wishes and thirdly encouraging them to push their individual goals hence enabling a greater sense of achievement for themselves within their limitations.What is it about PA work which appeals to you? (required): Working one to one enables both parties to reach a common goal - Trust, Friendship, Confidence and much more.What are your hobbies/interests?: Love Gardening and would love to have an allotment. Hunting in charity shops, Enjoy my twice yearly hols in the sunshine, Enjoy chatting with people.Would you consider a casual position if you are unsuccessful with this job? (required): YesDo you drive? (required): YesAre you a vehicle owner? (required): YesDo you smoke? (required): YesAre you able to undertake training? (required): YesWhat days/nights are you able to work, or prefer to work? (required): Tues - 09.30 - 12.30, Wed 14.00 - 17.00, Fri 09.30 - 16.30Are there any circumstances which would prevent you from providing cover or swapping a shift? (required): YesIf you would like to expand on the answers given above? Please use the box below.: Possible car failure or personal appts having been made.Is there is any such information you wish to disclose, relating to any cautions or convictions which will appear on your mandatory DBS check? (required): No/Please provide details if necessary: I have hoisted clients with m.s and m.n.d. I have also a vast knowledge Ive collected through working for care agencies and have experience with wheelchair users and their difficulties. I agree that there is nothing which would prevent me from doing this job. (required): YesI consent to the above (required): YesI agree that the information I provide will be posted to the Dewis CIL PA noticeboard (all personal information will be withheld).: YesWhat geographical area’s are you able to cover?: Cowbridge, Rhoose, Barry, St. AthanHow many hours of work can you offer per week?: Please see my availability section of the form.Please indicate the approximate times that you are available for work throughout the week.: Further Information: .