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Personal Assistant Application Form Submission

Title *: Ms.
First Name *: 
Last Name *: 
Address 1 *:
Address 2:
Town *: Cardiff
County *: Cardiff
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. *: Hello, I have 20 years experience in social care. I am moving to Gwaelod y Garth soon and would like to apply for this post as I have worked with many client groups before including older people and children.

What qualities do you think are important when working as a personal assistant with a disabled person? *: I am a patient, understanding and kind person. I am very flexible in my approach. I believe it is important to take on board the views of the client and their family in relation to the post. Communication skills are very important.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I am reliable in relation to my work. I enjoy working with people with disabilities which I have previously done in a variety of settings including households, day centres and camps in USA. I am a driver with business insurance and happy to visit local areas for the PA role.

What is it about PA work which appeals to you? *: I enjoy the one to one aspect and building a working relationship. I enjoy supporting people to make the best of their daily lives .

What are your hobbies/interests?: I am active - enjoy walking outdoors , cycling and swimming. I enjoy reading and eating out.

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? *: Weekends and evenings

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 would also need to consider my home circumstances.

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?: Cardiff , ideally North Treforest area

How many hours of work can you offer per week?: 10- Casual or Part Time

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

Further Information: I am registered with Social Care Wales