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Personal Assistant Application Form Submission

Title *: Mr.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Pontyclun
County *: Rhondda cynon taf
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 am working as a lunchtime assistant at present in a primary school in pencoed. Also I work for a charity in Merthyr as a volunteer youth worker. I help and support young children aged between 4-12 with activities of all types. I have been working as a lunchtime assistant since May last year first through an agency then by the school. I have been a volunteer youth worker since February 2018 and in that time I have supported many children of all backgrounds. I am also employed as a learning support assistant with an agency in Cardiff. I work well with 1 to 1 support or with small groups.

What qualities do you think are important when working as a personal assistant with a disabled person? *: Being reliable is important as is trust and respect for the child/young person. Being really patient is also important.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I can offer good one to one support for a disabled child. During the summer of 2018 I supported a young disabled girl who is a wheelchair user with day trips out and in a community centre with activities.

What is it about PA work which appeals to you? *: Pa work for me is the satisfaction of helping disabled children/ young people in any way possible.

What are your hobbies/interests?: I enjoy working with children/young people. I like to listen to music of most kinds. Also I like to watch sports of most kinds.

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? *: Yes

Are you able to undertake training? *: Yes

What days/nights are you able to work, or prefer to work? *: Mon to Fri afternoons from about 230 pm until 5 to 6 pm

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.:
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 Bridgend Rhondda

How many hours of work can you offer per week?: 10 to 15

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