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Personal Assistant Application Form Submission

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

Reference number of job being applied for *:

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 with children for the last 5 years but before that I cared for a lady in Rhoose that was disabled

What qualities do you think are important when working as a personal assistant with a disabled person? *: Honesty, reliable, understanding, caring, are just a few .

How do you think you can contribute towards the needs and the independence of a disabled person? *: I can help them to feel independent, help and care for them when needed , and listen to what they want to do and try to fulfill that .

What is it about PA work which appeals to you? *: I like to care and help people and build friendships.

What are your hobbies/interests?: I enjoy pottery on the weekend along with crafts such as card making, also reading .

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? *: I prefer to work between 9- 2 pm so I can be home to pick up my children.

Are there any circumstances which would prevent you from providing cover or swapping a shift? *: No

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)? *:

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

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.: Monday AM/Tuesday AM/Wednesday AM/Thursday AM/Friday AM/Saturday AM/Sunday AM/