Personal Assistant Application Form Submission

Title *: Miss.

First Name *:

Last Name *:
Address 1 *:

Address 2:

Town *: Mountain Ash

County *: Rhondda Cynon Taff

Postcode *:
Phone number *:
Please enter your email address for submission confirmation. *:
Reference number of job being applied for *: DP1481

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 spent the few year support people through, helping them understand forms and fill them in, helping them attend appointment and outings, offering advice or just listening. In my role current I am also in charge of running sessions from arts and crafts to the music group where I would take my guitar in and encourage and teach songs to others. I love singing and have been known for it in every job. Before becoming a support work I worked 10 years in a local pub where I enjoyed talking and getting to know my customers of all ages, I am easy to get on with and approachable.

What qualities do you think are important when working as a personal assistant with a disabled person? *: The most important qualities I feel working with a disabled person is patients and respect. Patients is needed as we are all different with different capabilities, patients helps the working relationship grow and to gain trust, whilst also helping to learn new skills or to maintain old. We should always respect each other and gain the respect of those we work with to be able to help, assist or just to be a friendly face, if you do not have patients and gain trust and respect, I feel you can not support the person to the best they deserve.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I am a bubbly person who loves to talk, even though my knowledge is slim on politics and sport I do like to know more and love talking to others about their passions. I have vast experience and knowledge of music as I like, sing and will try to play most. I have been to a few concert, shows and festivals over the years and feel we would have a lot to talk about as well as sing together. As well as having simular interest in music, I also enjoy spending time socialising over a coffee or a trip to the local and finding the funny side to life.

What is it about PA work which appeals to you? *: After working supporting others in both the private and third sector and have enjoyed helping and assissting others in many different ways. I feel I have the best personality for this role as I help, encourage and have a good track record of supporting others with varying abilities and health issues to live a life with independance, with my outgoing bubbly attitude.

What are your hobbies/interests?: My main interest are music from listening, playing, singing or attending shows. Watching films of nearly all genres. I love to draw and try new crafts, as well as watching documentary and cooking programs, then cooking new recipes.

Would you consider a casual position if you are unsuccessful with this job? *: Y

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? *: Any

Are there any circumstances which would prevent you from providing cover or swapping a shift? *: No

If you would like to expand on the answers given above? Please use the box below.:
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)? *: Manager
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

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 and Merthyr

How many hours of work can you offer per week?: 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/Tuesday Overnight/Wednesday AM/Wednesday PM/Wednesday Overnight/Thursday AM/Thursday PM/Thursday Overnight/Friday AM/Friday PM/Friday Overnight/Saturday AM/Saturday PM/Saturday Overnight/Sunday AM/Sunday PM /Sunday Overnight/
Further Information: