Personal Assistant Application Form Submission

Title *: Miss.

First Name *: 

Last Name *: 

Address 1 *: 

Address 2: Penywaun

Town *: Aberdare

County *: Rhondda Cynon Taf

Postcode *: 

Phone number *:

Please enter your email address for submission confirmation. *: JReference 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. *: My previous employment gives great experience to transfer to this job. Although I have never worked in the personal assistant sector, I have much experience working closely and also one to one with many regular customers in my current employment. There are many instances and regular customers that I deliver one to one shopping trips with. This is to help and assist them, or just keep them company throughout their shopping trip. I have worked with a variety of ages and multiple disabilities. I have worked with individuals with multiple sclerosis, autism, mental health, Asperger syndrome, Down syndrome and many other disabilities. These encounters allow me to either fully help people shop or just assist them when needs be.

What qualities do you think are important when working as a personal assistant with a disabled person? *: I think there are many qualities that are important when working as a personal assistant. No matter who you’re working with, whether the individual is disabled or not everyone should be treated equally and with the utmost respect. Respect for their wishes and needs and respect of privacy. Patience is vital, people within the personal assistant sector should be calm and patient at all times. They should have full knowledge and understanding that some individuals aren’t able to carry out certain tasks in the same manor or time scale as another individual. Each person is different and that is perfectly fine. Confidentially is critical. Ensuring there is no breach of confidentiality is of utmost importance. Following regulations and guidelines. Be kind, compassionate and caring. Always listen to what’s being said and don’t disregard what people say. Take interest and always be kind hearted. Always maintain and non judgemental attitude and be open minded in all you do. Those who require a person assistant are allowing you into their lives. You should be trustworthy and maintain a positive attitude.

How do you think you can contribute towards the needs and the independence of a disabled person? *: Being an outgoing and positive person can have a positive effect on someone, encouraging them to always try their best but making sure that there is no pressure. Helping out when required but always giving them the opportunity. I am always smiling and bubbly, love having a chat. I can build good rapport with individuals and get to know them on a greater level, understanding their needs. Knowing what their capabilities are along with limitations so I know where they may need help and what they might like to do on their own.

What is it about PA work which appeals to you? *: Many things appeal to me about PA work. The rewarding feeling knowing you have been able to help someone or even just make someone smile that day. Being able to be the reason that someone has built confidence or been able to leave the house or even just get out of bed that day would make my day. Getting to know new people and sharing similar interests, hearing old and new stories for different people from all different walks of life. I feel like I am in a job where the customer comes first and I really enjoy the one to one time I get assisting shoppers. I feel like I have done good.
What are your hobbies/interests?: I have many interests and hobbies. I enjoy the outdoors and fun activities. Sport is a massive love of mine. I spend a lot of time watching football and rugby. I do lots of this with my father and brother. I am very active and enjoy most sports. I am a very family oriented person and spend a lot of time with my partners, partner and two step children. I enjoy trips to the cinema, theatre, walks in the park and going to watch live music.

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? *: Monday to Friday all day Saturday morning and all day Sunday

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 *:

In what capacity do you know this person (should not be a family member)? *: Volunteer Placement

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?: South Wales

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/Saturday AM/Sunday AM/Sunday PM /
Further Information: