Personal Assistant Application Form Submission


Title *: Miss.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Barry
County *: The 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 was previously working with a gentleman with brain damage and a little dog, I took care of all his needs but still promoting independence throughout. I would take care of medical needs and medications. I would walk his dog with him and cook his food. Take him shopping and take him to courses that I apply for him such as pottery and wood work. I would ensure he washed daily and kept a high standard of hygiene. I would take him to the gym 3 times a week. Before this I was a deputy manager of a nursery for ten years..
What qualities do you think are important when working as a personal assistant with a disabled person? *: Being compassionate and caring. Understanding everyone’s needs and abilities. Maintaining professionalism. Listening and being patient.
How do you think you can contribute towards the needs and the independence of a disabled person? *: I can promote independence and build confidence. I am reliable and flexible and can always remain sympathetic. I am a positive person so will always see the best of any situation. I can ensure the person has social interaction as I am able to talk to anyone..
What is it about PA work which appeals to you? *: Being able to let the person live independent, feel safe and have the ability to carry out any task.
What are your hobbies/interests?: Hobbies and interests are Football, rugby, squash, running and cycling. I love photography and exploring new places.
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? *: Flexible
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.:

In what capacity do you know this person (should not be a family member)? *: Old Employer
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?: The vale of Glamorgan
How many hours of work can you offer per week?: 25
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/Thursday PM/Friday AM/Friday PM/Saturday AM/Sunday AM/
Further Information: