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Personal Assistant Application Form Submission

Title *: Ms.
First Name *:
Last Name *:
Address 1 *:
Address 2: Radyr
Town *: Cardiff
County *: South Wales
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 have previously bben a carer for an older, disabled member of my family. Duites have included washing hair and assisting with a shower. Help drying and getting dressed. Medication management and transporting to and from medical appointments. Helping with paper work and booking appointments. Over the years I have had a variety of jobs ranging from breakfast cook, catering assistant to admin and clerical work, to working with primary school children in a local primary school. A few years ago I briefly started training as a nursing student with the Cardiff and Vale Health Board but ended this course due to being a mature student. I have also worked as a Maternity Assistant at the UHW, caring for patients with a variety of needs and dealing with relatives.

What qualities do you think are important when working as a personal assistant with a disabled person? *: The qualities required when working with a person with a disability are to be understanding, listening and learning from the person at all times. To be patient and caring towards the individual person offering support when needed. Being able to be empathetic towards situations that the individual with the disability may find themselves experiencing.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I have had personal and professional experience of looking after a person/persons with varied disabilities. I know that promoting independence is very important and any assistance that is offered needs to be accepted by the person with the disability. All tasks taken on by the PA need to be explained and permission needs to be allowed and accepted by the individual.

What is it about PA work which appeals to you? *: Personal Assistance work has an appeal to my current circumstances with my home and family life. It also offers the chance to get back into the caring profession that I have previously worked in over the years.

What are your hobbies/interests?: Learning new subjects and taking on short courses, ranging from Social Psychology, Learning Support Assistant and Computer Studies. I enjoy reading and listening to Audio Books. Spending time with my family and walking my pet dog. I enjoy baking cakes at home and cooking new low calorie reciepes.

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 to Friday daytime hours.

Are there any circumstances which would prevent you from providing cover or swapping a shift? *: No

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

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?: North of Cardiff

How many hours of work can you offer per week?: under 20 hours

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/
Further Information: