243RCT

Personal Assistant Application Form Submission

Title *: Mrs.
First Name *:
Last Name *:
Address 1 *:
Address 2: Tonyrefail
Town *: Porth
County *: Mid glamorgan
Postcode *: CF39
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 am currently a domicillary care worker in the community. I have 20 years experience of autism with a severely autistic son
What qualities do you think are important when working as a personal assistant with a disabled person? *: Patience. Understanding and communication
How do you think you can contribute towards the needs and the independence of a disabled person? *: I am a very friendly bubbly person and I love taking care of others. I believe the role of careworker suits my personality and love of helping and caring for adults and children. I used to be a childminder and a teaching assistant
What is it about PA work which appeals to you? *: Helping others
What are your hobbies/interests?: I love to watch documentaries and read. I am a very family orientated person
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? *: Monday to Friday 10am _ 2PM every other weekend when Im not in work
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?: Rhondda cynon taff
How many hours of work can you offer per week?: 10/15
Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday Overnight/Tuesday AM/Tuesday Overnight/Wednesday AM/Wednesday PM/Thursday AM/Thursday PM/Friday AM/Friday PM/Saturday PM/Sunday PM /
Further Information: I work 3.30 to 10pm weekdays and every other weekend so am available in between those hours

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I am an 80 year old gentleman and I have been together with my wife for 56 years, We would like to employ a team of Carers to support us both at home to remain as independent and safe as possible. This would include personal care, general cleaning around the home & food preparation. Days/Nights available @ £10ph or £81 per night shift. Please read through the full job description before applying.
DP1490 Weekend Personal assistant.

60 year old woman living in Hirwaun. I live with my cat and my dog, a Westie called Tilly. I describe myself as a ‘happy-go-lucky’ person and feel I can chat to anyone. I enjoy the company of others. I like music especially Motown and Soul. I have MS and am a wheelchair user. I am a smoker so whoever works with me will need to be Comfortable with this. I am looking for a Personal Assistant who can assist me to maintain my independence at home. 5 hrs available @ £10.80 ph
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I’m a lady in my 70’s living in the Penygraig area with my husband who has a diagnosis of dementia. We also have a dog. I provide care for my husband 24/7. I have recently accepted the offer of support for a Personal Assistant to sit with my husband to provide me with some respite. I am looking for a Personal Assistant for carer sits. 6 hours per week, £10.50 per hour.

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