Personal Assistant Application Form Submission

Title *: Miss.

First Name *: .

Last Name *: .

Address 1 *: .

Address 2: Town *: Brecon

County *: Powys Postcode *: .

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 previously worked as a pharmacy delivery driver delivery medications to patients homes and to care homes. Before this I worked in the health care sector for eight years mainly looking after the elderly in the community and care homes

What qualities do you think are important when working as a personal assistant with a disabled person? *: Patience, kindness, helpful, friendly and most importantly caring. It is important to promote and maintain the person you are supportings independence.

How do you think you can contribute towards the needs and the independence of a disabled person? *:

I think I can contribute towards the needs and independence of a disabled person by the experience I have gained working in the care homes and also working as a delivery driver as you see a the person- an individual - not just a patient What is it about PA work which appeals to you? *: I have thought about PA work before but didnt consider the options fully. I think it is more person centred than the other jobs I have worked in as you spend more time one on one developing a relationship with the person you are supporting.

What are your hobbies/interests?: I enjoy listening to music, going to the cinema, occasionally baking and doing the odd bit of crafting. I am fairly new to the area but that means I would like to get out and explore but also still help other people day to day.

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? *: Fully flexible availability

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?: Brecon, Talgarth, Abergavenny, Crickhowell, Aberdare

How many hours of work can you offer per week?: 20

Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Tuesday AM/Tuesday PM/Thursday AM/Thursday PM/Saturday AM/Saturday PM/