Personal Assistant Application Form Submission


Title *: Miss.


First Name *: 


Last Name *: 


Address 1 *: 


Address 2: Aberdare


Town *: Mid Glamorgan


County *: RCT


Postcode *: CF44 

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 had 3 weeks experience in a care home where I helped get the patients up from bed and give them a wash in bed or took them to the toilet. I also assisted in given them their food and help feeding them if needed. I also hoisted them to the toilet.


What qualities do you think are important when working as a personal assistant with a disabled person? *: I have a great, friendly personality. I am flexible and patient. I am always organized and like to make sure I am on time. I have good communication skills and listening skills.


How do you think you can contribute towards the needs and the independence of a disabled person? *: I will make them feel valued and independent as possible. I will also take their choices and needs into account and will assist in making their life as easy as possible.


What is it about PA work which appeals to you? *: I have always had a passion for people and like to help others out when needed. I have always wanted to gain experience in care and making individuals lives happy and make sure they are treated appropriately.


What are your hobbies/interests?: My hobbies are taking part in a Jazz band and spending time with family.


Would you consider a casual position if you are unsuccessful with this job? *: Yes


Do you drive? *: No


Are you a vehicle owner? *: No


Do you smoke? *: Yes


Are you able to undertake training? *: Yes


What days/nights are you able to work, or prefer to work? *: Any


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.:


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?: Aberdare, Aberaman, Penywaun. Hirwaun, Trecynon
How many hours of work can you offer per week?: I can do any hours given


Please indicate the approximate times that you are available for work throughout the week.:
Further Information: