Personal Assistant Application Form Submission

Title *: Miss.
First Name *:
Last Name *:
Address 1 *:
Address 2: Cefn Hengoed
Town *: Cefn hengoed
County *: Mid Glamorgan
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 have 6years experience working within the community an 1 years experience working as a Pa to a young lady with cerebral palsy.
What qualities do you think are important when working as a personal assistant with a disabled person? *: Working with your client to maintain their independence in their day tilo day lives.
How do you think you can contribute towards the needs and the independence of a disabled person? *: I am a very hardworking confident women who as 6 years experience working with the elderly with various disabilities, Im reliable trustworthy. I can help with day to day duties while maintaining their independence.
What is it about PA work which appeals to you? *: I feel the role is extremely rewarding.
What are your hobbies/interests?: I enjoy days out with my family. Socialising with friends.
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? *: 9:30 - 4:30 Monday-Friday
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.: I work with a family every evening.

In what capacity do you know this person (should not be a family member)? *: .
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?: Caerphilly Cardiff
How many hours of work can you offer per week?: 9:30-4:30
Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday Overnight/Tuesday AM/Tuesday Overnight/Wednesday AM/Wednesday Overnight/Thursday AM/Friday AM/Friday Overnight/
Further Information: