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Personal Assistant Application Form Submission

Title *: Miss.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Llantwit Major
County *: Vale of Glamorgan
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 am currently a care assistant in home care. I attend clients homes and help them to maintain independence, I assist them with showering, personal care, meal preparations, social and shopping outings, light domestic duties, mobilising using various different mobility aids from hoists to wheelchairs.
What qualities do you think are important when working as a personal assistant with a disabled person? *: I believe being patient and ability to adapt to different situations are important. I am punctual, outgoing, open minded and have good communication skills with everyone I meet.
How do you think you can contribute towards the needs and the independence of a disabled person? *: I believe it is important to let the client lead and decide what is best for them I am open to the clients wishes and needs. I am adaptable and easygoing but always do my best to provide the best quality care for each individual
What is it about PA work which appeals to you? *: The variety of tasks, no day is the same and I feel I can give something back and help people live a good quality of life with lots of different experiences.
What are your hobbies/interests?: I enjoy walking my 2 dogs, I have just started running I volunteer for St. John ambulance as a first aider I enjoy reading, watching films and listening to music I have 3 children who I enjoy spending time with getting them outdoors we love the woods and beaches I also enjoy cooking and baking.
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? *: Monday Tuesday Wednesday Thursday Friday
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.: I am currently working all weekends and not seeing my children as much as I would like to so am looking for weekday work however would be happy to cover odd weekends
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
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?: Llantwit Major Wick Marcross St Athan Barry
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/Monday PM/Monday Overnight/Tuesday AM/Tuesday PM/Tuesday Overnight/Wednesday AM/Wednesday PM/Wednesday Overnight/Thursday AM/Thursday PM/Thursday Overnight/Friday AM/Friday PM/Friday Overnight/
Further Information: