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Personal Assistant Application Form Submission  


Title *: Ms. 

Town *: Barry 

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 worked in a nursing home and am looking for 121 work I have done all care certificates and my first aid training I'm happy outgoing and have a lot of experience  

What qualities do you think are important when working as a personal assistant with a disabled person? *: I have a updated dbs and have a lot of experience in care with my certificates. I have also worked as a PA and done dom care. I'm flexible I am always on time and can work all hours needed  

How do you think you can contribute towards the needs and the independence of a disabled person? *: I understand dignity respect and confidentially Im outgoing flexible and can work the hours needed and give independence and not take that away  

What is it about PA work which appeals to you? *: Working 121 and building a relationship with the client  

What are your hobbies/interests?: Swimming going for walks music cooking  

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? *: All hours needed  

Are there any circumstances which would prevent you from providing cover or swapping a shift? *: Yes 

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: Dbs clean on update service  

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?: All areas willing to drive  

How many hours of work can you offer per week?: 33-48 

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/Friday AM/Friday PM/Friday Overnight/Saturday AM/Saturday PM/Saturday Overnight/Sunday AM/Sunday PM /Sunday Overnight/ 

Further Information: