Personal Assistant Application Form Submission 

Title *: . 
First Name *:
Last Name  

Address 1 *:  
Address 2: Godreaman 
Town *: Aberdare 
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. *: I work alongside a day centre and residential home to do the clients hair. I have worked in this environment for 17 years and worked with many people suffering from varying degrees of dementia and Alzheimer’s. I also helped nurse my grandmother at home who had Alzheimer’s herself. 
What qualities do you think are important when working as a personal assistant with a disabled person? *: Patience is of great importance as the behaviour of the individual can become stressful as it can change hour by hour. You need to be calm and understanding. Being friendly as you must make the client feel comfortable and relaxed to they feel happy in your company not feeling distressed in any way. A good listener and communicator as people like to chat , so keeping the conversation going and allowing them to reminisce is important. To be alert and ensure they are safe cant bring danger to themselves and others. 
How do you think you can contribute towards the needs and the independence of a disabled person? *: I have worked with people of all ages and from all areas of society my positivity, compassion and my ability to empathise with others allow me to create relationships and friendships with them. I have also had to work with people suffering with complex mental health problems, especially in the nursing home where I regularly had too deal with the challenging behaviour. I often helped patients with other tasks, whether it was just sitting with them and chatting for a while or helping at mealtimes. My flexibility and willingness to do above and beyond my specific hairdressing duties, enabled me to develop relationships built on mutual trust and respect. 
What is it about PA work which appeals to you? *: I have worked with people all my life and love to get to know them. I feel I can really make difference to someone’s life by giving them a little bit of time and attention and giving the family the well deserved break they need. Having been in the position of caring for my grandmother with Alzheimer’s you understand the importance of what can be offered and I feel I can give that. 
What are your hobbies/interests?:I’m a big fan of family time. I love the outdoors, so I walk and jog a lot. I read a lot. 
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? *: Tuesday, Saturday, Sunday 
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.:I care for my grandson once a week either Wednesday or Thursday but would only have dates monthly when my daughter receives her shifts. So could do whichever day was free that week. 
Name *:
In what capacity do you know this person (should not be a family member)? 
Phone Number *:  
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?: 10 
Please indicate the approximate times that you are available for work throughout the week.: Tuesday AM/Tuesday PM/Tuesday Overnight/Saturday AM/Saturday PM/Saturday Overnight/Sunday AM/Sunday PM /Sunday Overnight/ 
Further Information: