204RCT

Personal Assistant Application Form Submission

Title *: Miss.
First Name *:
Last Name *:
Address 1 *:
Address 2: Gilfach goch
Town *: Porth
County *: Wales
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 independent living be for looking after husband and wife , in their home taking them out, I'm also a carer at the moment
What qualities do you think are important when working as a personal assistant with a disabled person? *: Making sure their needs are met ,
How do you think you can contribute towards the needs and the independence of a disabled person? *: Taking them out doing stuff , and meeting their needs
What is it about PA work which appeals to you? *: Just a bubbly person who loves helping other people with needs makes me feel happy ,
What are your hobbies/interests?: Love spending time with my kids and my fiance and family , I'm a outgoing person who loves meeting new people
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? *: Days
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.:

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. *: No
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?: Gilfach goch tonyrefail trebanog williamstown
How many hours of work can you offer per week?: 10 to 15 hours
Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Wednesday AM/Thursday AM/
Further Information: I work 24 hours a week but would love to help out in my spare time,

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