Personal Assistant Application Form Submission

Title *: 

First Name *:

Last Name *: 

Address 1 *:

Address 2: Hirwaun

Town *: Aberdare

County *: Rhondda Cynon Taff

Postcode *:
Phone number *:
Please enter your email address for submission confirmation. *:

Reference number of job being applied for *: DP1169

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 done care since I was 18 I am now 32.i have 3 children in full time school my previous job was as a branch manager of a care company for 3 years. I have done a lot of training to help with my job role as a carer and manager with liasing with safe guard and social workers.

What qualities do you think are important when working as a personal assistant with a disabled person? *: To help with keeping their independence at all times. Help prompt and support and always be open minded with new challenges. I adapt very very well to change and challenges.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I am a very easy person to get along with I have done one to one carer before and coming from care since 18 I have a lot of experience to all different disabilities.
What is it about PA work which appeals to you? *: I enjoy the one to one support which give 100% to the person which builds up trust and independence with each other.
What are your hobbies/interests?: I enjoy going places with my 3 children. They play a lot of sports such as rugby and football. I enjoy swimming and going to the gym. I have two dogs which I enjoy going for nice walks with.

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? *: Yes
Are you able to undertake training? *: Yes

What days/nights are you able to work, or prefer to work? *: I can work Monday to Friday 830am to 3pm and can do Monday to Friday every night 9pm onwards and I can do every other weekend day and night

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.: Short notice cover or advance the problem would only be my children but my family are very good in helping with this as I have done care before and this has happened and they have helped if they can.

Name *:

Job Title *:
Address *:

Phone Number *:
In what capacity do you know this person (should not be a family member)? *: Cheryl was my manager when I worked under her as a manager for qcare

Name *:
Job Title *:
Address *:
Phone Number
In what capacity do you know this person (should not be a family member)? *: Was my old manager when I worked for qcare as a senior care coordinator

Is there is any such information you wish to disclose relating to any convictions? *: 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 Mountain ash Hirwaun Penderyn All off RCT

How many hours of work can you offer per week?: 45

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/Saturday AM/Saturday PM/Sunday AM/Sunday PM /
Further Information: