Personal Assistant Application Form Submission


Title *: Mrs.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Hengoed
County *: Caerphilly
Postcode *: CF82 
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 worked with a young woman with cerebral palsy last year who was completely dependant , a wheelchair user also with no speech . I did this alongside my admin job initially for extra money but enjoyed it so much that I left my admin job in January this year to become a Support worker and Personal Assistant to two separate clients . Unfortunately the Support Worker role is not as I expected and I spend long periods with nothing to do so I am looking for a position where I am needed more .
What qualities do you think are important when working as a personal assistant with a disabled person? *: Treating the person with dignity and respect . Listening , having patience . Being encouraging and positive. Being kind and reassuring , building trust.
How do you think you can contribute towards the needs and the independence of a disabled person? *: I have all of the qualities mentioned in the previous question and already implement them in my current positions
What is it about PA work which appeals to you? *: Job satisfaction in knowing you are doing your best to make someones life easier . Flexibility , the opportunity to work extra shifts .
What are your hobbies/interests?: Animals , property renovation, long walks with my dog
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? *: Monday , Tuesday, Thursday , Friday , every other Saturday , and Sunday
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.: Working with my other client

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?: Cardiff
How many hours of work can you offer per week?: 20-25
Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Monday Overnight/Tuesday AM/Tuesday PM/Thursday AM/Thursday PM/Friday AM/Friday PM/Saturday AM/Saturday PM/Saturday Overnight/Sunday AM/Sunday PM /Sunday Overnight/
Further Information: