Personal Assistant Application Form Submission


Title *: Mr.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Merthyr Tydfil
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. *: On Tuesdays and Saturdays I look after a blind and disabled man aged 36 in the Aberdare area. Ive been looking after this client for over a year now.
What qualities do you think are important when working as a personal assistant with a disabled person? *: I think its essential to be understanding, empathetic, observant and reliable at all times, while demonstrating strong communication. I also think its important to be caring and have a good sense of humour.
How do you think you can contribute towards the needs and the independence of a disabled person? *: I am an outgoing person so this means I can contribute towards improving communication skills and confidence.
What is it about PA work which appeals to you? *: I have always been a caring person, I enjoy putting other peoples needs before my own.
What are your hobbies/interests?: I enjoy gaming, going to the cinema and exercising.
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? *: I can do days, evenings and nights. Im in college on Mondays, however, I am available for work after college hours. Im available all week except for Tuesdays and Saturdays, these days Ill be available from 5pm.
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.:

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 currently do not have a DBS check, but, I am in the process of getting one.
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?: Merthyr Tydfil, Rhondda Cynon Taf
How many hours of work can you offer per week?: 30
Please indicate the approximate times that you are available for work throughout the week.: Monday PM/Tuesday AM/Tuesday Overnight/Wednesday AM/Wednesday PM/Wednesday Overnight/Thursday AM/Thursday PM/Thursday Overnight/Friday AM/Friday PM/Saturday AM/Saturday Overnight/Sunday AM/Sunday PM /
Further Information: