Personal Assistant Application Form Submission

Title *: Mrs.
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 *:
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 qualified as an Occupational Therapist in 1995 and worked in Social Services until 2007 when I left to work with my husband. During this time I worked with a number of people living with Dementia and their families especially during my 4 year training as I worked in a hospital with a dedicated Dementia unit. I also looked after my mother in law in our own house for a year and she suffered with Dementia.
What qualities do you think are important when working as a personal assistant with a disabled person? *: A caring nature and understanding of the difficulties some one with a disability has. An ability to be flexible, listen and treat everyone as a person. You need to be able to adapt to the needs of the person, include them in the plans for their day and remain cheerful and positive
How do you think you can contribute towards the needs and the independence of a disabled person? *: I have experience of working with people with disabilities and as an Occupational Therapist the ethos was very much on enabling people to live independent lives. I have a caring nature and a desire to assist some one to have as much independence as possible and to live the best life they can and want
What is it about PA work which appeals to you? *: Ability to get to know some one and their associated family and friends well and so hopefully be able to offer help that they require and want. It would be nice to be able to spend time with some one to build up a good relationship
What are your hobbies/interests?: I enjoy walking my dog, reading, gardening, family time with family meals, walks and holidays, being active in my local church and doing some volunteer work with a local charity ( Baby basics in Barry). My husband and I also enjoy holidays in the U.K.
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 am able to work Mon - Wed daytime and Thursday morning, also Friday daytime and possibly Saturday afternoon and Sunday morning. I would prefer not to do any night time work but could do some early evenings
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 could probably cover/swap shifts providing I had some notice but generally I dont have many fixed things that I couldnt change around to cover

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, Sully and Penarth
How many hours of work can you offer per week?: up to 20 hours
Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Tuesday AM/Tuesday PM/Wednesday AM/Wednesday PM/Thursday AM/Friday AM/Friday PM/Saturday AM/Sunday AM/
Further Information: