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Personal Assistant Application Form Submission

Title *: Miss.
First Name *: 
Last Name *:
Address 1 *:
Address 2:
Town *: Cardiff
County *: Cardiff
Postcode *:
Phone number *:
Please enter your email address for submission confirmation. *:

Reference number of job being applied for *:

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 worked in both secure units, domiciliary care and also as a personal assistant in the past. I have a wide variety of customer service experience and am able to work well with people of all backgrounds. ProCare Nursing – August 2016 – January 2017 (Health care support worker) Helping Hands Homecare – January 2017 – June 2017 Well Pharmacy – April 2017 – October 2017 (Relief Dispenser) Wales Cancer Trials Research – June 2017 – August 2017 (Pharmacovigilance and Safety assistant) Conduit Call Centre – November 2017 – June 2018(Customer service advisor) Wales Cancer Trials Research – June 2018 – September 2018 (Summer contract Pharmacovigilance and Safety assistant) Crwys Pharmacy – April 2019 – present (Dispensing assistant) All roles I have worked in have some essence of care and person centred care involved.

What qualities do you think are important when working as a personal assistant with a disabled person? *: Communication is a key quality, the service user must be able to communicate well with their assistant and vice versa. Trust and integrity are also very important as you are being trusted with the care of the person you are assisting. Building a relationship would make both parties ore natural and comfort and allow for the best out of having the personal assistant.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I am a very hard working individual and will always do my best to individualise my actions and role to the person I am working with. I would build that relationship to ensure I know what is best for them and that I am performing my role to the best possible standard.

What is it about PA work which appeals to you? *: The role of a PA is about promoting independent living and enhancing a persons quality of life to not allow them to be restricted due to their medical conditions. This to me is such an important and rewarding role to be a part of making someones life a little better and ensuring they have their needs me to enable them to live life as normally as possible.

What are your hobbies/interests?: I like to keep fit and regularly attend the gym. I also have a love for baking and do a lot of this in my spare time.

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? *: Evenings and days around uni

Are there any circumstances which would prevent you from providing cover or swapping a shift? *: No

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? *: No

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?: varied

Please indicate the approximate times that you are available for work throughout the week.: Monday PM/Tuesday PM/Wednesday PM/Thursday PM/Friday PM/