Personal Assistant Application Form Submission

Title *: Mrs.
First Name *:
Last Name *: 
Address 1 *: 
Address 2: Bonvilston
Town *: Cowbridge
County *: Vale of Glamorgan
Postcode *: CF5 
Phone number *: 
Please enter your email address for submission confirmation. *: 


Reference number of job being applied for *: 


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. *: My previous employment has been as a receptionist/administrator/audio typist. I have worked as a support worker for people on the autistic spectrum. I am reliable, hardworking and very friendly. I am caring and loyal and as per the job description, I understand the lady has a Chihuahua. I have a Chihuahua and enjoy taking her for walks especially around Dyffryn Gardens where I am a member.


What qualities do you think are important when working as a personal assistant with a disabled person? *: Patience Understanding of the needs of the individual An excellent rapport with people Respect Being aware of the limitations that the disabled person has and what they enjoy doing Being a driver Being fit and healthy Happy to help Enjoying the role Compassion and empathy Being sociable and outgoing Being a good cook Being trustworthy and have integrity Being intelligent and have good conversational skills.


How do you think you can contribute towards the needs and the independence of a disabled person? *: By finding out exactly what the disabled person can and cant do. Also, finding out what they like and dislike. Assisting the person to be as independent as they can without exceeding their limitations. Striking up a warm and supportive relationship with the person.


What is it about PA work which appeals to you? *: I am looking for a job that allows me to help others who may be unable to do the things that they would like to do but who, with the help of a companion can carry on with their lives to allow them a good quality of life. I understand that one day I may be disabled and would like to think that someone would be happy to work with me to allow me to reach a certain level of independence and who could make me feel safe and to show me kindness. I like to fact that the role is one which had an element of friendship attached and where no two days are there same. I am a 54 year old housewife and my two children have now left home and I would like to find a job which gets me out and about and that allows me to earn a small amount of money in the process, and which is rewarding and interesting.


What are your hobbies/interests?: Yoga, Pilates, reading (Im in 2 reading groups), walking my little chihuahua, gardening, line dancing, Tai Chi, travelling and sightseeing, eating out, my 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 to Friday 9 - 6, unfortunately I am not able to commit to working at weekends.
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 agree that there is nothing which would prevent me from doing this job. *: Yes
I consent to the above *: Yes
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
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?:
How many hours of work can you offer per week?:
Please indicate the approximate times that you are available for work throughout the week.:


Further Information: