Personal Assistant Application Form Submission

Title *: Mrs.
First Name *:
Last Name *:
Address 1 *:
Town *: Tonypandy
County *: Mid glamorgan
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 have done care work for nearly 30yrs I’ve just really enjoyed my last 5yrs with a young man and want to continue in the care sector
What qualities do you think are important when working as a personal assistant with a disabled person? *: A lot of patience and empathy are key qualities along with love and kindness
How do you think you can contribute towards the needs and the independence of a disabled person? *: I always encourage independence but will assist when needed. I like to be able to bring them a smile and give them a reason to be happy
What is it about PA work which appeals to you? *: It is the only job that I have done that brings job satisfaction I love to make a difference
What are your hobbies/interests?: Love theatre, cinema, musicals badminton and baking
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? *: Quite flexible can’t do Wednesday evenings or Sunday mornings
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.:

In what capacity do you know this person (should not be a family member)? *: Worked alongside with Susan taking our service user on holidays etc
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 Bridgend Cardiff Llantwit Major Cowbridge Barry
How many hours of work can you offer per week?: 20-40
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/Thursday Overnight/Friday PM/Friday Overnight/Saturday Overnight/Sunday Overnight/
Further Information: