Personal Assistant Application Form Submission 

Title (required): . 
First Name (required):  
Last Name (required): 
Address 1 (required):  
Address 2: Beddau 
Town (required): Pontypridd 
County (required): RCT 
Postcode (required):
Phone number (required):  
Please enter your email address for submission confirmation. (required) 
Reference number of job being applied for (required): 
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. (required): 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. (required): I have recently started working with Dewis as a personal care assistant. Previous to this I spent 13 years as a nursery nurse. During this time I have worked with children with a variety of needs. I have gained valuable experience and training, including paediatric first aid. 
What qualities do you think are important when working as a personal assistant with a disabled person? (required): I believe being positive, happy and enthusiastic is essential. Ensuring the safety of the child at all times and being respectful of each individuals needs or requirements. The well being of the person is very important too. Confidentiality and building trust is also a key factor. 
How do you think you can contribute towards the needs and the independence of a disabled person? (required): I am highly experienced and have gained various qualifications, including inclusion training. I am young, enthusiastic, full of energy and always happy to entertain children. I am a good communicator with children and easily form bonds. I believe I can promote independence and bring out even the quietest of children. 
What is it about PA work which appeals to you? (required): I have always had a desire to help people. I think helping people is very rewarding. I have a magnetic personality and this allows me to help a huge variety of people. I am good hearted and a compassionate person who doesnt judge, regardless of anyones circumstances. 
What are your hobbies/interests?:My hobbies are anything related to Star Wars, Marvel and DC comics. I enjoy gaming and anything nerdy and geeky. I love the outdoors, going for walks in the countryside and generally having fun. 
Would you consider a casual position if you are unsuccessful with this job? (required): Yes 
Do you drive? (required): Yes 
Are you a vehicle owner?  (required): Yes 
Do you smoke? (required): No 
Are you able to undertake training? (required): Yes 
What days/nights are you able to work, or prefer to work?  (required): I am very flexible and would work with the service user to arrange the most convenient times. 
Are there any circumstances which would prevent you from providing cover or swapping a shift? (required): No 
If you would like to expand on the answers given above? Please use the box below.:I am local, living in Beddau myself. this would allow me to be even more flexible to the service user. 
Name (required):
In what capacity do you know this person (should not be a family member)?  (required):  
In what capacity do you know this person (should not be a family member)?  (required): 
Is there is any such information you wish to disclose, relating to any cautions or convictions which will appear on your mandatory DBS check? (required): No/ 
Please provide details if necessary: I have a valid and active portable DBS so I can start straight away. 
I agree that there is nothing which would prevent me from doing this job. (required): Yes 
I consent to the above (required): 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?: Beddau, Pontypridd, Llantrisant, Church Village, TontegPontyclun 
How many hours of work can you offer per week?: 30 
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: