Personal Assistant Application Form Submission

Title *: Ms.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Pontypridd
County *: Rhondda Cynon Taff
Postcode *: CF37 
Phone number *:
Please enter your email address for submission confirmation. *:

Reference number of job being applied for *: DPC1495

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. *: June to August 2019: Wisconsin Badger Camp I worked for 3 months as a camp counselor. This camp is specialised in welcoming campers with different types of disabilities. I have learned many skills during my time there that I believe will be of use to do this job.

What qualities do you think are important when working as a personal assistant with a disabled person? *: I believe being patient, trustworthy, understanding and kind are important.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I think that by helping with the little tasks and just by being present I can help a disabled person become more confident.

What is it about PA work which appeals to you? *: While working last summer, I discovered that helping others was a feeling that I wanted to continue having. It is a fulfilling job that enables me to meet, help and connect with other people.

What are your hobbies/interests?: I like reading, watching movies/shows, listening to music and travelling. I also love animals.

Would you consider a casual position if you are unsuccessful with this job? *: No
Do you drive? *: Yes
Are you a vehicle owner? *: No
Do you smoke? *: No
Are you able to undertake training? *: Yes
What days/nights are you able to work, or prefer to work? *: Availabilities: Monday, Tuesday, Wednesday (until 8:30am and after 1:30pm), thursday (until 11:30am then after 4:30pm), friday (until 12:30pm and after 4:30pm), saturday, Sunday

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.: I go to university so there are certain hours when I won’t be available (see availabilities).

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?: Pontypridd Cardiff
How many hours of work can you offer per week?: 25 to 30
Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Monday Overnight/Tuesday AM/Tuesday PM/Wednesday PM/Thursday AM/Thursday PM/Friday PM/Friday Overnight/Saturday AM/Saturday PM/Saturday Overnight/Sunday AM/Sunday PM /Sunday Overnight/
Further Information: