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Personal Assistant Application Form Submission

Title *: Miss.
First Name *:
Last Name *:
Address 1 *:
Address 2: Machen
Town *: Caerphilly
County *: Mid Glamorgan
Postcode *:
Phone number *:
Please enter your email address for submission confirmation. *:
Reference number of job being applied for *: Any
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 worked in the care industry for nearly 15 years. I am vert passionate about care and have been a PA over 8.5 years.
What qualities do you think are important when working as a personal assistant with a disabled person? *: I am reliable, friendly, caring, compassionate and understand the need for confidentiality. I am an outgoing person, easy to get along with and always puts the needs of the service user first.
How do you think you can contribute towards the needs and the independence of a disabled person? *: I always respect service users privacy and needs and like to treat everyone as an individual instead of as a disabled person. I like to contribute to helping peoples lives and remaining as independence as possible.
What is it about PA work which appeals to you? *: As stated previously, I have worked as a PA for many years and believe that as a PA you can build relationships with service users that you wouldnt necessary get with an agency. It brings continuity for the service users and myself.
What are your hobbies/interests?: Walking, reading, animals, family, eating out, cinema, music, computers, studying.
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? *: Yes
Are you able to undertake training? *: Yes
What days/nights are you able to work, or prefer to work? *: Monday (Eve), Friday (Eve), Sunday (Morning and Eve) (all day)
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 already a PA to 2 service users. Although both are very flexible.
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
Please provide details if necessary:
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 (all areas) Vale of Glamorgan (Penarth)
How many hours of work can you offer per week?: 10 hours to fit around service users I have already
Please indicate the approximate times that you are available for work throughout the week.:
Further Information: