Personal Assistant Application Form Submission

Title *: 

First Name *: 

Last Name *: 

Address 1 *: 

Address 2:


Town *: Barry
County *: Vale Of Glamorgan

Postcode *: 

Phone number *: 

Please enter your email address for submission confirmation. *:

Reference number of job being applied for *: VOG670
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 experience working in the care field as worked for a few years in residential homes and have done domestic cleaning for the elderly which also involved meal preparation and doing some personal errands
What qualities do you think are important when working as a personal assistant with a disabled person? *: Good qualities to have are kindness compassion understanding patience and friendly nature

How do you think you can contribute towards the needs and the independence of a disabled person? *: I have some experience in helping people maintain an independent lifestyle and understand how important it is

What is it about PA work which appeals to you? *: I currently work in a Primary school doing breakfast club and lunchtime supervisor so this would fit into these hours and I enjoying getting to know and work with people

What are your hobbies/interests?: I am currently a brownie leader and have done this for many years and also spend a lot of time with my family in Somerset

Would you consider a casual position if you are unsuccessful with this job? *: No
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 - 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.:
Name *: Rhws primary school

Job Title *: Secretary


Address *:
Phone Number *: 

In what capacity do you know this person (should not be a family member)? *: Employer

Name *: 

Job Title *: 

Address *: 

Phone Number *: In what capacity do you know this person (should not be a family member)? *: District commissioner for girl guiding

Is there is any such information you wish to disclose, relating to any cautions or convictions which will appear on your mandatory DBS check? *: 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?: Barry/Rhoose

How many hours of work can you offer per week?: 5

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