246RCT Personal Assistant Application Form Submission Title *: Ms.First Name *: Last Name *: Address 1 *: Address 2: Town *: Tonyrefail 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. *: 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. *: Educated to gcse standardWhat qualities do you think are important when working as a personal assistant with a disabled person? *: I think you have to be a special person,a kind caring person with a big heart with lots of love to giveHow do you think you can contribute towards the needs and the independence of a disabled person? *: I could give my time ,I also have plenty of patience with the vulnerable What is it about PA work which appeals to you? *: I am already a PA to two other people in Dewis,and know I am doing a good job,I get pleasure out of doing a good job taking care of others.What are your hobbies/interests?: My hobbies are going to the gym.long walks,socialising with friends.Would 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? *: Through the week,no weekends 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.: 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?: RCTHow many hours of work can you offer per week?: 25Please indicate the approximate times that you are available for work throughout the week.: Monday PM/Tuesday AM/Tuesday PM/Wednesday PM/Thursday AM/Thursday PM/Thursday Overnight/Friday AM/Friday PM/Further Information: