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Personal Assistant Application Form Submission

Title *: Mr.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Cardiff
County *: Glamorgan
Postcode *:
Phone number *:
Please enter your email address for submission confirmation. *:
Reference number of job being applied for *: CDP318

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 currently have 2 clients that I take out into the community and we thoroughly enjoy our time together.

What qualities do you think are important when working as a personal assistant with a disabled person? *: Creating a safe and positive living environment Enjoying daily living skills such as budgeting, shopping Providing leisure and creative activities in a safe and supportive setting Helping to deal with problems and become independent Liaising with residents families and arranging family and home visits Working with other health and care professionals Acting as a learning support assistant

How do you think you can contribute towards the needs and the independence of a disabled person? *: Checking each clients needs and progress Providing physical care, which could include bathing, toiling, dressing and feeding Creating a safe and positive working and living environment Helping with daily living skills such as budgeting, shopping, out into the community. Providing leisure and creative activities in a safe and supportive setting Helping clients to deal with problems and become independent Liaising with families and arranging family and home visits Working with other health and care professionals.

What is it about PA work which appeals to you? *: Organising and assisting with recreational activities. I get so much enjoyment in my ability to help others is so satisfying with my sense of humour.

What are your hobbies/interests?: I enjoy golf,football,rugby, snooker.

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? *: not available on Wednesday or a Friday

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.: Wednesdays are a as and when requirement so may be open to change.

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

How many hours of work can you offer per week?: 30

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