Reference #

4924176 / 57RCT

Status

Complete

Title

Mrs.

First Name

Last Name

Address 1

Address 2

Tonypandy

Town

Tonypandy

County

Mid Glamorgan

Post Code

cf40 

Phone

Email Address

Job reference number

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 been working in Care since January 2018. I have worked with Elderly and Disabilities, in that time I have gained a SCIE certificate which allows me to work in care as a registered Social Care Support Worker.

What qualities do you think are important when working as a personal assistant with a disabled person?

Cheerful, trustworthy, respectful, confident, empathetic, dignity.

How do you think you can contribute towards the needs and the independence of a disabled person?

Promoting well being, and encouraging an individual to do tasks independently where possible to give them a self of achievement.

What is it about PA work which appeals to you?

Getting to know an individual and supporting them to do what they would like to do on a daily basis. Encouragement in areas that they would normally have enjoyed .. supporting them to have a fulfilled life.

What are your hobbies/interests?

I enjoy most things, music, theatre, sport, musicals, reading and travel.

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?

unable to work nights at present but any day is suitable.

Are there any circumstances which would prevent you from providing cover or swapping a shift?

Yes

Would you like to expand on the answers given above? Please use the box below.

Any morning or day or evening shift would be acceptable but nights I am unable to do at present.

Name

Title

Address

Phone

In what capacity do you know this person (should not be a family member)?

Name

Title

Address

Phone

In what capacity do you know this person (should not be a family member)?

Rehabilitation of Offenders Act 1975 * Within the nature of the work for which you are applying this position is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1975 (Exemptions Order). Applicants are therefore not entitled to withhold information about convictions which for other purposes are ‘spent’ under the provisions of this Act. In the event of employment, any failure to disclose such convictions could result in dismissal. Information given is confidential and will only be considered for the purposes of the application. If there is any such information you wish to provide?

No

I agree that there is nothing which would prevent me from doing this job.

Yes

The organisation will hold your data on file for twelve months after the end of the relevant recruitment process if you provide consent. The purpose of retaining your data with your consent is to allow you to apply easily for other jobs we may have available. At the end of the twelve months period you will be required to complete a new application form in order to remain on our system. You may withdraw your consent for us to hold your data at any time after the initial recruitment process is completed. I consent for my personal data to be held and agree that Dewis CIL may keep this application form on file for twelve months. It may be used for future prospective employers. I understand that you will contact me in due course should any such person make themselves known to you.

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?

Tonypandy and most of RCT

How many hours of work can you offer per week?

20 plus

Please indicate the approximate times that you are available for work throughout the week.

  Early Morning

·         Monday

·         Tuesday

·         Wednesday

·         Thursday

·         Friday

·         Saturday

·         Sunday

  Late Morning

·         Monday

·         Tuesday

·         Wednesday

·         Thursday

·         Friday

·         Saturday

·         Sunday

  Early Afternoon

·         Monday

·         Tuesday

·         Wednesday

·         Thursday

·         Friday

·         Saturday

·         Sunday

  Late Afternoon

·         Monday

·         Tuesday

·         Wednesday

·         Thursday

·         Friday

·         Saturday

·         Sunday

  Evenings

·         Monday

·         Tuesday

·         Wednesday

·         Thursday

·         Friday

·         Saturday

·         Sunday

Last Update

2019-09-05 12:03:19