Personal Assistant Application Form Submission

Title *: Mrs.
First Name *:
Last Name *:
Address 1 *:
Address 2: C
Town *: Cowbridge
County *: Vale of Glamorgan
Postcode *:
Phone number *: 1
Please enter your email address for submission confirmation. *: Reference number of job being applied for *: 1
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 used to teach digital inclusion to residential homes, libraries and was Administration Officer for Wales Co-operative Centre. Previous to that I was a Legal Secretary for many years.
What qualities do you think are important when working as a personal assistant with a disabled person? *: Treat them like a friend, give them the respect they deserve. Make them feel relaxed and boost their confidence.
How do you think you can contribute towards the needs and the independence of a disabled person? *: I think I would be a good person, because I am very caring, thoughtful and like seeing people happy.
What is it about PA work which appeals to you? *: I would love to start doing this just to supplement my income and be more active.
What are your hobbies/interests?: I love country walks, shopping, swimming, animals, I take care of my nieces quite a lot.
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? *: Week days, preferably afternoons.
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 *: 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?: Cowbridge
How many hours of work can you offer per week?: 15
Please indicate the approximate times that you are available for work throughout the week.: Monday PM/Friday PM/
Further Information: Possibly more, I’m flexible