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Personal Assistant Application Form Submission

Title *: Mrs.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Cardiff
County *: South Glamorgan
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. *: n.a
What qualities do you think are important when working as a personal assistant with a disabled person? *: • Multi-tasking • Time management • Being thorough and paying attention to detail • Showing patience and remaining calm under pressure • Keeping my workspace clean, tidy and organised
How do you think you can contribute towards the needs and the independence of a disabled person? *: I am a hard working and dedicated indiidual and have 2 of my own children who I care for daily.
What is it about PA work which appeals to you? *: I enjoy helping people and keeping busy.
What are your hobbies/interests?:
Would you consider a casual position if you are unsuccessful with this job? *: Yes
Do you drive? *: No
Are you a vehicle owner? *: No
Do you smoke? *: No
Are you able to undertake training? *: Yes
What days/nights are you able to work, or prefer to work? *: every day no nights
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? *: Yes
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
How many hours of work can you offer per week?: 16
Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Tuesday AM/Tuesday PM/Wednesday AM/Wednesday PM/Thursday AM/Thursday PM/Friday AM/Friday PM/Saturday AM/Saturday PM/Sunday AM/Sunday PM /
Further Information: