Personal Assistant Application Form Submission

Title *: Mrs.

First Name *:

Last Name *: 

Address 1 *: Address 2: Quakers Yard

Town *: Treharris

County *: Mid Glam

Postcode *: 

Phone number *: 

Please enter your email address for submission confirmation. *: Reference number of job being applied for *: DP1545

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 previously worked in different sectors within the NHS supporting patients with knee and hip replacements, stroke patients and those with mental health issues which has enabled me to understand and care for a variety of people. I have learnt a great deal and am able to adapt these skills to different people and situations.

What qualities do you think are important when working as a personal assistant with a disabled person? *: I believe that patience and understanding are vital when caring for others. It is imperative that a person feels comfortable in your care and also to be trusted at all times.

How do you think you can contribute towards the needs and the independence of a disabled person? *: By listening to what the individual needs and wants and delivering a friendly, caring environment for that person

What is it about PA work which appeals to you? *: I enjoy helping people and making them happy. It’s important to see people succeed in every day life and making it as enjoyable as possible

What are your hobbies/interests?: I really enjoy walking my dog, having a coffee and going to the cinema. I’m happy to do most activities and trying new things

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 available on Mondays and some weekends

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 would be available to cover and swap shifts providing childcare is in place for my son
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 cautions or convictions which will appear on your mandatory DBS check? *: 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