Personal Assistant Application Form Submission 

Title *: Ms. 
First Name *: 
Address 2: 
Town *: Treherbert 
County *: RCT 
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. *: Although I have worked in a different industry over the past twenty years, caring for others has always been at the core of my work. I have a diploma in Nursing, and although I am not a current practitioner, my medical knowledge is up-to-date. I have also worked with learning disability groups and many vulnerable people in my previous job at the Royal British Legion. Most of the club members were elderly, isolated or medically vulnerable. I formed strong bonds and organised many events, social groups and peer networks to support them. As well as caring for some members in my own time, for example taking them out shopping, to cafes and events and making sure they are looked after. This was particularly important during the first national lockdown, I checked in with my members daily, often did their shopping, organised deliveries and made sure that they felt cared for. 
What qualities do you think are important when working as a personal assistant with a disabled person? *: Active listening, patience and offering care proactively I believe would be the most important in order to make sure that the medical, social and the care needs of the person are met. I also think that it would be important to be organised and diligent in practice to make sure that the care plans are followed exactly. 
How do you think you can contribute towards the needs and the independence of a disabled person? *: It is firstly important to understand the needs of the person and what success (however small) would look like for the person. I am an excellent communicator and I am able to build strong and caring relationships to support the people. I also proactively seek solutions and ways of working that allow people to feel supported whether its emotional or medical support. 
What is it about PA work which appeals to you? *: After many years of working in a different industry, I deeply want to work and help people directly. My experience of looking after the elderly or medically vulnerable people at my previous post was often a highlight of my day. I believe that it is important now more than ever to make sure that everyone gets the care that they deserve, regardless of the level of need. 
What are your hobbies/interests?:Travelling, reading, knitting & crocheting, going out, shopping. 
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? *: Monday - Sunday 
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.: 
Name *:
In what capacity do you know this person (should not be a family member)? *:
In what capacity do you know this person (should not be a family member)? *: 
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?: RCT 
How many hours of work can you offer per week?: 40 
Please 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/Saturday AM/Saturday PM/Sunday AM/Sunday PM / 
Further Information: