21VOG Personal Assistant Application Form Submission Title *: Miss.First Name *: Last Name *: Address 1 *:Address 2:Town *: BRIDGENDCounty *: Vale of glamorganPostcode *: CF32 Phone number *:Please enter your email address for submission confirmation. *: Reference number of job being applied for *: 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. *: My last 3 jobs have been as a personal assistant through dewis cil. I have experience with young people in their 20s who have either autism or epilepsy. I currently care for a lady in the Vale who has regular seizures. What qualities do you think are important when working as a personal assistant with a disabled person? *: My qualities are understanding and empathy. To be on the same wave length as the person I am caring for. How do you think you can contribute towards the needs and the independence of a disabled person? *: I can bring a welcoming smile of support. Knowing when my help is needed or to shadow and promote independence. What is it about PA work which appeals to you? *: I like the flexibility of knowing what days and times I am needed. And plenty of notice and agreement if times need to change. The pay is above average which is helpful. What are your hobbies/interests?: My hobbies are baking cakes at home with my children. Going for meals out, bingo, cinema and spending time with friends. Would you consider a casual position if you are unsuccessful with this job? *: NoDo you drive? *: YesAre you a vehicle owner? *: YesDo you smoke? *: NoAre you able to undertake training? *: Yes What days/nights are you able to work, or prefer to work? *: Mon-fri Are there any circumstances which would prevent you from providing cover or swapping a shift? *: NoIf you would like to expand on the answers given above? Please use the box below.: I have school age children so I am hoping to work between 9.45-2.00pm 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).: Yes What geographical area’s are you able to cover?: Bridgend Ogmore by sea Brynna Porthcawl Llantwit major How many hours of work can you offer per week?: 20Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Tuesday AM/Wednesday AM/Thursday AM/Friday AM/Further Information: I own my own car. Non smoker. 29 year old female.