Personal Assistant Application Form Submission

Title *: Miss.
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. *: I currently work in the care industry and have done so for the past 5years
What qualities do you think are important when working as a personal assistant with a disabled person? *: I think you need patience and understanding as every person is different and has different needs
How do you think you can contribute towards the needs and the independence of a disabled person? *: Being able to help and give assistance in everyday living
What is it about PA work which appeals to you? *: To form a bond with the person work on a one to one basis to get to know likes and dislikes and help them though daily life
What are your hobbies/interests?: I love anything outdoors from walking to gardening love going to the cinema and the theatre reading
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? *: No
Are you able to undertake training? *: Yes
What days/nights are you able to work, or prefer to work? *: Any fixed days of the week either one or two full shifts aswel as covering sick and holidays when given notice
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.: Would need a weeks notice


Is there is any such information you wish to disclose, relating to any cautions or convictions which will appear on your mandatory DBS check? *: 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?: Newport to ely
How many hours of work can you offer per week?: 72
Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Monday Overnight/Tuesday AM/Tuesday PM/Tuesday Overnight/Wednesday AM/Wednesday PM/Wednesday Overnight/Thursday AM/Thursday PM/Thursday Overnight/Saturday AM/Saturday PM/Saturday Overnight/Sunday AM/Sunday PM /Sunday Overnight/
Further Information: