Personal Assistant Application Form Submission


Title *: Mrs.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Pontypridd
County *: Rct
Postcode *: Cf37 
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. *: Have spent the last 16 years caring for my son with Downs syndrome,ADHD and OCD.He now lives independently , so I have experience of challenging behaviour first hand.I also recognise the unique struggles of parents that have children with special needs.I have a nephew and niece that have autism and recognise that they are in different places on the same spectrum. Before caring for my son I worked with adults with learning difficulties in their own home.
What qualities do you think are important when working as a personal assistant with a disabled person? *: Persistence.Patience.Many of the people who initially offered to care for my son did not have the patience to get to know him.
How do you think you can contribute towards the needs and the independence of a disabled person? *: I hope that my struggles as a parent will help me better understand the needs of both the disabled person and their families.
What is it about PA work which appeals to you? *: I hope I have something to offer other families due to my experiences over the years.
What are your hobbies/interests?: I like reading and good long walks.I hope to develop more hobbies and interests now that my son is living independently.
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? *: Afternoons evenings preferred due to my husbands early shifts
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.: Childcare.Though we can be mostly flexible.


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?: RCT.
How many hours of work can you offer per week?: Afternoons and evenings most days
Please indicate the approximate times that you are available for work throughout the week.: Monday PM/Tuesday PM/Wednesday PM/Thursday PM/Friday PM/Saturday PM/Sunday PM /
Further Information: