Personal Assistant Application Form Submission


Title *: 
First Name *: 
Last Name *:
Address 1 *: 
Address 2: Aberaman.
Town *: Aberdare
County *: Mid Glamorgan
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 currently work in the Primary school Education sector, having retrained from my previous industrial background. I have under gone various training in First aid, Communication, Confidentiality and various other courses.
What qualities do you think are important when working as a personal assistant with a disabled person? *: To respect, listen and try to understand the needs or the person at that time, trying to promote a feeling of self worth, to promote inclusion in all of parts of lifes daily challenges. To help prepare, guide, support. But I think most of all to offer the hand of friendliness with all its traits humour, companionship etc.
How do you think you can contribute towards the needs and the independence of a disabled person? *: Empathy, Patience, understanding, diligence, confidentiality.
What is it about PA work which appeals to you? *: The feeling of helping someone young or old, through the difficult times, to comfort in the sad times and share happy times, to try and make life as positive and inclusive as possible.
What are your hobbies/interests?: I enjoy all sports, taking part and watching, I love the outdoors walking, sitting and viewing scenery discovering new places to go both local and traveling, cinemas, music, theatre, reading especially sport bios, meeting people and communicating.
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/Fri late afternoons, early evenings, occasional weekends.
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.: My son was born disabled, and have been there by his side on all his chosen paths, but now he has grown into adulthood and found his own independence. We have had lots of people who have helped, I think I have developed over the years a sense of wanting to give something back, now this is my time.
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?: Cynon Valley / R.C.T
How many hours of work can you offer per week?: Twenty
Please indicate the approximate times that you are available for work throughout the week.: Monday PM/Tuesday PM/Wednesday PM/Thursday PM/Friday PM/
Further Information: Due to work commitments ( school) I would not be available till after 3pm