Personal Assistant Application Form Submission


Title *: .


First Name *: 


Last Name *: 


Address 1 *: 


Address 2:


Town *: Pontypridd


County *: RCT


Postcode *: Phone number *


Please enter your email address for submission confirmation. *:


Reference number of job being applied for *: 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 worked on the homecare for 10yrs. I was a PA for a gentleman for 10yrs who suddenly passed away Dec.2019.


What qualities do you think are important when working as a personal assistant with a disabled person? *: I believe the qualities important in this role are having patience, being flexible in your approach and being respective, understanding and compassion helps you understand how others feel so you can respond to their needs appropriately. Good communication is essential. I am very loyal.


How do you think you can contribute towards the needs and the independence of a disabled person? *: I can provide them with support to help the person be as independent as possible and maintain their current skills and when possible introduce them to new tasks, hobbies and enjoy the time we spend together.


What is it about PA work which appeals to you? *: I have worked in the caring profession for the last 20yrs.


What are your hobbies/interests?: walking, swimming, shopping, cinema, bingo, hairdressing
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? *: Day Shifts


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)? *: Employer (on behalf of Lyndon Johns)


Name *:


Job Title *: /
Address *: Phone Number *:


In what capacity do you know this person (should not be a family member)? *: Previous 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?: Rhondda Cynon Taff
How many hours of work can you offer per week?: Anything up to 15hrs
Please indicate the approximate times that you are available for work throughout the week.:
Further Information: I would prefer to work with an adult