Personal Assistant Application Form Submission

Title *: Mr.

First Name *: Matthew

Last Name *: Webb

Address 1 *:

Address 2: Rhoose


County *: Vale of Glamorgan

Postcode *:

Phone number
Please enter your email address for submission confirmation. *:
Reference number of job being applied for *: VOG519

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 have worked in customer related jobs that deal with customers on a one to one basis. Ive previously been associated with the Scout Movement and also have three young children of my own. In these roles I have needed to be calm, patient and understanding to peoples needs and situations.

What qualities do you think are important when working as a personal assistant with a disabled person? *: Understanding what the individual needs, and is able to achieve at their own pace. Having a lot of time and not rushing or upsetting the individual. Also, being a companion for them.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I feel that I have a lot to offer, as I am a caring and patient person. I feel that everyone deserves a good life regardless of their situation and if I am able to help them achieve this it would be rewarding.

What is it about PA work which appeals to you? *: Giving someone the chance to live their life to the full, or have a companion with similar interests to improve their standard of living.

What are your hobbies/interests?: I am a musician (keyboards & guitars), I enjoy film and most sci-fi and historic TV. I am a games console fan. I have an interest in the history and people of WW2. I am also a huge Star Wars and Lego fanatic.

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? *: Wednesday and Thursday 10am-2pm, and Tues - Friday evenings 6pm-9pm

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.: Childcare

Name *:

Job Title *: Address *:

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

Name *:

Job Title *:
Address *:
Phone Number *:
In what capacity do you know this person (should not be a family member)? *: Manager when working for Boots Opticians

If there is any such information you wish to provide? *: 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?: Rhoose and Cardiff

How many hours of work can you offer per week?: 16hrs

Please indicate the approximate times that you are available for work throughout the week.: Tuesday PM/Wednesday AM/Wednesday PM/Thursday AM/Thursday PM/Friday PM/
Further Information: