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Personal Assistant Application Form Submission

Title *: Ms.
First Name *:
Last Name *:
Address 1 *:
Address 2: Ely
Town *: Cardiff
County *: South 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 worked weekends at St Winifreds Care Home for 4 years tending to the elderly womens needs and on e male. Toileting, bathing, feeding, taking outside in a wheelchair for fresh air etc.. I worked at the Romilly Care Home too. Both these jobs for approx 4 years and both in Canton.

What qualities do you think are important when working as a personal assistant with a disabled person? *: Patience, understanding, kindness, good health (self), cheerful, friendly, interested in the individual being cared for.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I believe I can contribute to the independence of a disabled person by being positive minded and helpful. Get to know the persons abilities and encourage them to do their best.

What is it about PA work which appeals to you? *: Id like to work on to one with the individual, or one other if it was necessary. I dont like crowds. The flexibility of the assignments would be good to fit around being a single mum of 3 children living under my roof which I am responsible for.

What are your hobbies/interests?: Religion- Christianity Art and Crafts- knitting Walks in the park Crossword

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

Do you drive? *: Yes

Are you a vehicle owner? *: No

Do you smoke? *: No

Are you able to undertake training? *: Yes

What days/nights are you able to work, or prefer to work? *: I would ideally prefer to work the hours that my children are in school- term time 10am - 2pm.

Are there any circumstances which would prevent you from providing cover or swapping a shift? *: Yes

If you would like to expand on the answers given above? Please use the box below.: I am the only one that can look after my children. No family or close friends to call on. Although I have a clean full driving licence I dont own a car. I would be using buses.

Name *:
Job Title *:
Address *:
Phone Number *:
In what capacity do you know this person (should not be a family member)? *:
Name *:
Job Title *:
Address *:
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

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?: Ely, Canton, Fairwater, City centre

How many hours of work can you offer per week?: 8 hours to start off with which could be broken down between 2 clients if necessary.