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Personal Assistant Application Form Submission

Title *: Mr.

First Name *:

Last Name *:

Address 1 *:

Address 2: Penylan

Town *: Cardiff

County *: Cardiff

Postcode *:

Phone number *:

Please enter your email address for submission confirmation. *:

Reference number of job being applied for *:

Give details of your previous employment or experience which you think would help you to do this job. *: I have extensive customer service experience, dealing with people in a friendly and approachable manner having worked for William Hill and Ladbrokes as well as Virgin and HMV. I also have a years experience working as a teaching assistant in schools across Cardiff providing 1:1 and group support.

What qualities do you think are important when working as a personal assistant with a disabled person? *: I think the qualities that are important when working as a personal assistant are to be understanding, trustworthy and empathetic and understand the challenges faced by disabled people. Its important to be respectable, responsible and reliable, have a good sense of humour, be flexible and always willing to learn, whilst a commitment to equality and diversity is also very important.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I am a good listener and have excellent interpersonal skills as well as excellent written and verbal communication skills. I have good local knowledge of the Cardiff area and treat people with dignity and respect. I can help with personal care, domestic cleaning, cooking/meal prep and support going out in to the community to do various activities.

What is it about PA work which appeals to you? *: Being able to help and support people to live their life in the way that they choose and help make a real positive change to their life.

What are your hobbies/interests?: My main interests are music, i am a musician and enjoy playing and listening to music, I am also a big sports fan, particularly football, rugby and snooker. I enjoy nature and going for walks, reading and cooking.

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? *: No

Are you able to undertake training? *: Yes

What days/nights are you able to work, or prefer to work? *: I am flexible to work days/nights over 7 days as required for the roles applied for.

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

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?: Penylan, Cyncoed, Roath, Splott, Adamsdown, Canton

How many hours of work can you offer per week?: 25

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 /