175RCT

Personal Assistant Application Form Submission

Title *: Mr.

First Name *:

Last Name *:

Address 1 *:

Address 2:

Town *: Mountain Ash

County *: Mid Glamorgan

Postcode *:

Phone number *:

Please enter your email address for submission confirmation. *: Reference number of job being applied for *: DP818

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. *: Currently working as a PA through Dewis C.I.L assisting a young gentleman to access the community and maintain his independence. Prior to this I was also a PA supporting a boy with autism to also access the community to provide his mother with some respite. I also have experience working as a domiciliary support worker providing all aspects of care and support to a variety of people with different religions.
What qualities do you think are important when working as a personal assistant with a disabled person? *: To be very supportive and understanding of someones individual needs. To respect someones home and wishes. Have a good understanding of confidentiality and privacy. To be able to be flexible. To be willing to participate with activities.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I feel from experience that it is beneficial to promote someones independence rather than trying to take over everything which would have the opposite effect.

What is it about PA work which appeals to you? *: The rewarding nature of the job and also the degree of flexibility involved.

What are your hobbies/interests?: I love spending time outdoors and swimming. I am always open to trying new sports or activities and learning different cultures.

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? *: Anything with the exception of Thursday evenings.

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.: I believe that when supporting someone to gain independence it is most effective to act more as a friend as this would make them feel more at ease and calm any nerves. I am honest and punctual with a can-do attitude.
Name *: I WILL BE HAPPY TO PROVIDE REFERNCES AT INTERVIEW STAGE
Job Title *: N/A
Address *: N/A
Phone Number *: N/A
In what capacity do you know this person (should not be a family member)? *: N/A
Name *: I WILL BE HAPPY TO PROVIDE REFERENCES AT INTERVIEW STAGE
Job Title *: N/A
Address *: N/A
Phone Number *: N/A
In what capacity do you know this person (should not be a family member)? *: N/A
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, MERTHYR TYDFIL, BRIDGEND, CARDIFF, NEWPORT, PONTYPRIDD, BLACKWOOD, CAERPHILLY, VALE OF GLAMORGAN
How many hours of work can you offer per week?: Anything up to 30
Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Tuesday AM/Tuesday PM/Wednesday AM/Wednesday PM/Thursday AM/Thursday PM/Friday AM/Friday PM/Saturday AM/Saturday PM/Sunday AM/Sunday PM /
Further Information: MALE WITH PERSONAL ASSISTANT AND CARE EXPERIENCE LOOKING FOR EXTRA WORK. DRIVER WITH OWN VEHICLE. NON SMOKER.

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