Personal Assistant Application Form Submission

Title *: Mrs.
First Name *:
Last Name *:
Address 1 *:
Address 2: Tyla Garw
Town *: Pontyclun
County *: Mid Glam
Postcode *: CF72
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 a daughter with special needs myself who is living independently now. I would like to help a person who is in need of support.
What qualities do you think are important when working as a personal assistant with a disabled person? *: work on own initiative patience understanding the disability Learning about the person flexibility reliability confidentiality dignity and respect
How do you think you can contribute towards the needs and the independence of a disabled person? *: By being myself. I am reliable and I have a good sense of humor and I understand the importance of confidentiality. I enjoy helping people so I wouldnt find it a chore. I love animals. I also drive and have access to my own car
What is it about PA work which appeals to you? *: Helping to make a difference to peoples lives, work on own initiative and is trustworthy and honest.
What are your hobbies/interests?: music - all sorts reading - or listening to books via Audible cooking - is a passion enjoying housework
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? *: Yes
Are you able to undertake training? *: Yes
What days/nights are you able to work, or prefer to work? *: Any
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 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?: Any around Pontyclun in a distance of 20 miles
How many hours of work can you offer per week?: 40
Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Monday Overnight/Tuesday AM/Tuesday PM/Tuesday Overnight/Wednesday AM/Wednesday PM/Wednesday Overnight/Thursday AM/Thursday PM/Thursday Overnight/Friday AM/Friday PM/Friday Overnight/Saturday AM/Saturday PM/Saturday Overnight/Sunday AM/Sunday PM /Sunday Overnight/
Further Information: