Personal Assistant Application Form Submission

Title *: Miss.

First Name *:

Last Name *: 

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 been a carer for 19 years and also worked as a one to one carer in that time so I am able to work both independently and as part of a team, I have a warm and friendly approach with a strong work ethic and a genuine passion for providing the vulnerable with a high quality care and support

What qualities do you think are important when working as a personal assistant with a disabled person? *: Always putting the person first and being able to complete a task no matter how big or small they might be, making sure your always available for the person to contact you with excellent time keeping skills, being understanding and patient is very important in this job role as you need to keep them feeling as independent as possible
How do you think you can contribute towards the needs and the independence of a disabled person? *: By supporting them with all their needs and tasks but also keeping the individual as independant as possible

What is it about PA work which appeals to you? *: Organising and supporting individuals with their needs, Helping individuals with booking and going to appointments and social events with them, Helping with personal care such showering, dressing etc and supporting them with tasks around the house such as cleaning and cooking

What are your hobbies/interests?: Spending time with my family Walking I enjoying setting myself daily goals and then completing them

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? *: Yes
Are you able to undertake training? *: Yes

What days/nights are you able to work, or prefer to work? *: Flexible weekdays

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 *:
In what capacity do you know this person (should not be a family member)? *: Previously worked for him

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?: Merthyr Tydfil

How many hours of work can you offer per week?: 25 hours

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