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Personal Assistant Application Form Submission

Title *: Miss.
First Name *:
Last Name *:
Address 1 *:
Address 2: Fairwater
Town *: Cardiff
County *: South Glam
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 have experience in support work out in the community taking a young man to his different activities and ensuring hes safe and more importantly having fun.

What qualities do you think are important when working as a personal assistant with a disabled person? *: Good listener, calm, adaptable to different situations, making sure the environment is safe, good sense of humour.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I think of myself as a positive person with a good sense of humour and I would like to think I would be more a friend then a carer and assist when needed but still allowing independence.

What is it about PA work which appeals to you? *: Socialising, caring, helping people and the flexibility.

What are your hobbies/interests?: Cinema, reading, eating out and socialising

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? *: Days, Monday - Friday

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

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?: Fairwater, Canton, Ely, Llandaff, Danescourt and surrounding areas.

How many hours of work can you offer per week?: 11

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