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Personal Assistant Application Form Submission

Title *: Miss.
First Name *:
Last Name *:
Address 1 *:
Address 2: Ely
Town *: Cardiff
County *: Sourh 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 have previously worked in various roles which required me to communicate with other persons on different levels via telephone, email and in person. I am currently working in a charity shop to gain further experience with people. I can cook, clean, i drive, I have three children so have experience in caring for others. I do not smoke and consider myself quite fit.

What qualities do you think are important when working as a personal assistant with a disabled person? *: I think you must be trustworthy,caring,kind and helpful. Must also be reliable.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I am willing to help in whatever way I would be needed...any physical work..gardening etc, any personal care, shopping, any other trips needed..doctors appointments etc,going for walks

What is it about PA work which appeals to you? *: I like to help people and would get great satisfaction from a job like this.

What are your hobbies/interests?: I do not have much spare time for myself as I am bringing up three children on my own but I do like to cook,taking kids out to the park,football etc

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? *: During school hours preferably 10-2 mon to fri

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.: School holidays

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? *: Yes

Please provide details if necessary: Over 20 years ago, I was involved in an altercation with my ex partner in which I was charged with assault which I deeply regret.

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 west

How many hours of work can you offer per week?: Up to 24

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/