Personal Assistant Application Form Submission

Title *: Mr.

First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Blackwood

County *: Gwent



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 for stagecoach as a bus driver , over my time here Ive worked with the public lots with different back grounds and needs , some with mental disabilities and those with psychical disabilities. I always try my best to help those with need to ensure they get to and from there destinations with ease.

What qualities do you think are important when working as a personal assistant with a disabled person? *: The qualities that I find vital is that you must remain pateint and understanding at all times , everyone is a individual and need help with different tasks , from those who have social problems and those who have psychical disorders . Even when issues arrise it is important to stay calm to give the best possible result.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I am very laid back and understanding over a large number of matters i can handle alot of situations in a professional manner and take the clients health and wellbeing in to a high matter.

What is it about PA work which appeals to you? *: Being able to make a difference in some Ones life , to give them the best out look in life and being able to take some weight of their shoulders with general day to day tasks
What are your hobbies/interests?: I enjoy music and history, I started studying a degree in psychology. I enjoy going to museums and my life ambition would be to write a book about the human mind. I enjoy watching movies of all aspects and Im a. Big family person. I enjoy playing strategy games as I enjoy a good brain teaser
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? *: I am quite flexible but would ideally like a few hours here and there to work around my working life
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.: Sometimes would be hard to get time off from my day job at short notice so would need a minimum of two weeks notice so I could arrange cover

Name *:
Job Title *:

Address *: Phone Number
In what capacity do you know this person (should not be a family member)? *:
Name *:

Job Title *: Address *:

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

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?: RCT, Merthyr, Gwent

How many hours of work can you offer per week?: 8

Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Tuesday AM/Wednesday AM/Thursday AM/Friday AM/Saturday AM/
Further Information: