Personal Assistant Application Form Submission

Title (required): Ms.
First Name (required):
Last Name (required):
Address 1 (required):
Address 2:
Town (required): Cardiff
County (required): South Glamorgan
Postcode (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): 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. (required): For the past nine years I have had the pleasure and privilege to have been working for a 83 yrs old wheelchair user. Dealing with all tasks and needs required to assist this lady to remain as independent and maintain as good a quality of life as possible.
What qualities do you think are important when working as a personal assistant with a disabled person? (required): Understanding the individual’s needs. Patience, care and empathy. Reliability, trust and good communication.
How do you think you can contribute towards the needs and the independence of a disabled person? (required): Having worked for the past 9 years caring for a elderly wheelchair user I feel I have the knowledge and understanding to give the person a quality and high standard of care, commitment, to enable them to have an enhanced quality of life.
What is it about PA work which appeals to you? (required): Making a difference to someone’s life.
What are your hobbies/interests?: Walking, swimming, gardening, badminton, dancing, live music, quizzes, local history, history of WWI and Second World War, photography.
Would you consider a casual position if you are unsuccessful with this job? (required): Yes
Do you drive? (required): Yes
Are you a vehicle owner?  (required): Yes
Do you smoke? (required): No
Are you able to undertake training? (required): Yes
What days/nights are you able to work, or prefer to work?  (required): Flexible
Are there any circumstances which would prevent you from providing cover or swapping a shift? (required): No
If you would like to expand on the answers given above? Please use the box below.: It’s sad circumstances which I am applying for this job as the lady I worked for for almost nine years passed away. She would have given me the highest reference had she been here to do so, her family whose I have become friends with know how much this lady thought of myself and her other PA of 14 years and will be willing to provide a reference on her behalf. I’ve enjoyed my time with her, meeting her many friends and taking her to places of interest, I like to feel I gave her an excellent quality of life and personal care.
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 agree that there is nothing which would prevent me from doing this job. (required): Yes
I consent to the above (required): 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?: Vale of Glamorgan Cardiff South
How many hours of work can you offer per week?: 25 approximately
Please indicate the approximate times that you are available for work throughout the week.: Tuesday AM/Tuesday PM/Wednesday AM/Thursday AM/Thursday PM/Friday AM/
Further Information: I have put a preference for days and hours but am able to work hours to suit the client and can be flexible.