Personal Assistant Application Form Submission

Title *: Mr.
First Name *:
Last Name *:
Address 1 *:
Address 2: Cilfynydd
Town *: Pontypridd
County *: Mid glam
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 previously worked on the roads meeting various customers setting up traffic lights.
What qualities do you think are important when working as a personal assistant with a disabled person? *: Patience good communication skills.
How do you think you can contribute towards the needs and the independence of a disabled person? *: I am an easily approachable person ov a placid nature.
What is it about PA work which appeals to you? *: I enjoy helping people I have a brother who used to suffer with fits hes ok now. I basically take him on away trips rugby etc because he wouldnt be able to do these things alone.
What are your hobbies/interests?: Enjoy bit of keep fit. Watching my kids play rugby. Socializing and listening to various types of 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? *: Any apart from Thursday evening and Sunday morning but would be willing to swap
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 am also first aid trained

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?: Pontypridd rct beddau mtn ash
How many hours of work can you offer per week?: 16
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/Friday AM/Friday PM/Friday Overnight/Saturday AM/Saturday PM/Saturday Overnight/Sunday PM /Sunday Overnight/
Further Information: None