Personal Assistant Application Form Submission


Title *: Miss.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Aberdare
County *: RCT
Postcode *: Cf44
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 worked as a PA in the past with a lady who had MS so Im fully aware and capable of all the hard work that needs to be done. I done everything from bathing to dressing her, using the hoist and transferring her safely to her wheelchair, I also done light household cleaning and took her out.
What qualities do you think are important when working as a personal assistant with a disabled person? *: To be easy going, compassionate, good at time keeping, trustworthy, have a lot of patience and in general just be a all round good person.
How do you think you can contribute towards the needs and the independence of a disabled person? *: I will listen to their needs, help and support them in every way I can.
What is it about PA work which appeals to you? *: I like to care for people.
What are your hobbies/interests?: Walking. Reading. Shopping.
Would you consider a casual position if you are unsuccessful with this job? *: Yes
Do you drive? *: No
Are you a vehicle owner? *: No
Do you smoke? *: No
Are you able to undertake training? *: Yes
What days/nights are you able to work, or prefer to work? *: Most days and nights as long as I can get transport easily.
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.:

In what capacity do you know this person (should not be a family member)? *: She was my employer
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?: Mostly aberdare area as long as I got transport.
How many hours of work can you offer per week?: 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/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/
Further Information: