Personal Assistant Application Form Submission


Title *: Mrs.


First Name *: 


Last Name *: 


Address 1 *:

Address 2:


Town *: Barry


County *: Wales


Postcode
Phone number *: 


Please enter your email address for submission confirmation. *:

Reference number of job being applied for *: Vog625


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 worked with a disabled man who has angle syndrome


What qualities do you think are important when working as a personal assistant with a disabled person? *: Someone who is kind willing to help and enjoy what they do


How do you think you can contribute towards the needs and the independence of a disabled person? *: I’m hard working willing to do what ever is needed


What is it about PA work which appeals to you? *: I loved working with the lad I was with and I like the one to one


What are your hobbies/interests?: Spending time with my kids


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? *: Any time


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)? *: Family friend


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?: Vale of Glamorgan
How many hours of work can you offer per week?: 20
Please indicate the approximate times that you are available for work throughout the Week.