216RCT Personal Assistant Application Form Submission Title *: Mrs.First Name *: Last Name *: Address 1 *: Address 2: Town *: Tonypandy 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. *: YesPlease 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. *: Ive worked for dewis for the last 2 and half years the lady i looked after unfortunately died i also work down the royal glamorgan hospital in the evenings where i have been for the last 20 years as a cleaner What qualities do you think are important when working as a personal assistant with a disabled person? *: It is important to give the client space when needed and also make sure they feel safe at all times and respect their feelings and dignity How do you think you can contribute towards the needs and the independence of a disabled person? *: I will try to help them out in the community and will help them any way i can .What is it about PA work which appeals to you? *: I like helping people who are not able to do for themselves whether this is going shopping or just for a meal .What are your hobbies/interests?: My hobbies are spending time with family also like watching soaps and taking my dogs for walks Would you consider a casual position if you are unsuccessful with this job? *: YesDo you drive? *: YesAre you a vehicle owner? *: YesDo you smoke? *: YesAre you able to undertake training? *: YesWhat days/nights are you able to work, or prefer to work? *: Monday Wednesday Thursday Friday Saturday availability 9till2Are there any circumstances which would prevent you from providing cover or swapping a shift? *: YesIf you would like to expand on the answers given above? Please use the box below.: I start down the hospital at 3 so can work before that time 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. *: YesI consent to the above *: YesI agree that the information I provide will be posted to the Dewis CIL PA noticeboard (all personal information will be withheld).: YesWhat geographical area’s are you able to cover?: Rhondda How many hours of work can you offer per week?: 16plusPlease indicate the approximate times that you are available for work throughout the week.: Monday AM/Wednesday AM/Thursday AM/Friday AM/Saturday AM/Further Information: