226RCT Personal Assistant Application Form Submission Title *: Mrs.First Name *: Last Name *: Address 1 *: Address 2: Town *: rhonddaCounty *: mid-glamPostcode *: cf41Phone 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. *: i have been working for a family supporting there son with cerebral palsy, for 4 years but have been made redundant, i also supported a lady who i took out shopping and social events who passed away What qualities do you think are important when working as a personal assistant with a disabled person? *: to give the person as much support as possible, and make sure they are safe at all timesHow do you think you can contribute towards the needs and the independence of a disabled person? *: to help with there personal needs , and assist with things they want to doWhat is it about PA work which appeals to you? *: job satisfaction , to help other peopleWhat are your hobbies/interests?: knitting ,crafts, shows, most types of music ,bingoWould you consider a casual position if you are unsuccessful with this job? *: YesDo you drive? *: YesAre you a vehicle owner? *: YesDo you smoke? *: NoAre you able to undertake training? *: YesWhat days/nights are you able to work, or prefer to work? *: week daysAre 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.: 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 vallyHow 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/Monday PM/Tuesday AM/Tuesday PM/Wednesday AM/Wednesday PM/Thursday AM/Thursday PM/Friday AM/Friday PM/Further Information: will be available for weekends now and again