Personal Assistant Application Form Submission


Title *: Mrs.


First Name *: Holly


Last Name *: Barry


Address 1
Address 2:


Town *: Merthyr Tydfil


County *: Mid Glamorgan


Postcode
Phone number *:
Please enter your email address for submission confirmation. *:


Reference number of job being applied for *: DPM1359


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’ve got a niece who has Down Syndrome and I’ve worked for someone who was Paralysis who could not walk, talk, or eat ect. I’ve also done cleaning in private home, MOD contracts and commercial


What qualities do you think are important when working as a personal assistant with a disabled person? *: To have a bond with the person ,communicate at all times and making sure the person has everything he/she needs without overcrowding


How do you think you can contribute towards the needs and the independence of a disabled person? *: I can carry out all aspects of personal care, domestic cleaning, arrange appointments and make sure all meds are taken and re-ordereding to make thing easier for the person


What is it about PA work which appeals to you? *: I love helping people where-ever possible


What are your hobbies/interests?: Gardening, spending time with family


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-Friday 9am-4pm


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.:


Name *:


Job Title *:

Address *:

Phone Number *:
In what capacity do you know this person (should not be a family member)?
Name *:

Job Title *:


Address *:
Phone Number *:
In what capacity do you know this person (should not be a family member)? *:

If there is any such information you wish to provide? *: Yes


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?: Merthyr Tydfil
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/
Further Information: