Personal Assistant Application Form Submission


Title *: Mr.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Merthyr Tydfil
County *: Mid Glamorgan
Postcode *: CF48  
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 suitable for this post, as i have worked as a personal assistant for the past 25 years. I have worked with many different clients and have a lot of experience.
What qualities do you think are important when working as a personal assistant with a disabled person? *: I am a reliable, trustworthy individual who is always willing to go the extra mile. I am a good listener, punctual and patient. I am a quick learner and confident. I work well in a team, however i equally work well on my own.
How do you think you can contribute towards the needs and the independence of a disabled person? *: I think that it is extremely important to maintain the independence of any individual. I am a patient person who would encourage any individual to be independent where possible.
What is it about PA work which appeals to you? *: I think after doing the job for the past 25 years, being a PA is very rewarding. I like to help people and support them achieve what they want in life.
What are your hobbies/interests?: I enjoy watching variety of sports, also taking my dog for a walk. I also enjoy attending concerts by various artists.
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? *: No
Are you able to undertake training? *: Yes
What days/nights are you able to work, or prefer to work? *: Mon, tues, wed, Fri
Are there any circumstances which would prevent you from providing cover or swapping a shift? *: Yes
If you would like to expand on the answers given above? Please use the box below.: Due to having another client with Dewi Cil, i am unable to work weekends.

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?: Merthyr Tydfil, aberdare
How many hours of work can you offer per week?: 16
Please indicate the approximate times that you are available for work throughout the week.: Monday PM/Tuesday PM/Wednesday PM/Friday PM/
Further Information: