Personal Assistant Application Form Submission


Title *: Miss.


First Name *: 

 Last Name *: 


Address 1 *:

Address 2:


Town *:
County *: Rhondda Cynon taff

Postcode *:
Phone number *:
Please enter your email address for submission confirmation. *:

Reference number of job being applied for *: DP009


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. *: Previous emplyment. I worked at McDonalds Glynneath for almost 2 years before I left for maternity leave. I had my daughter and was unable to return to work due to no childcare. I also worked part time at a few pubs during this time. My experience doing this gave me the opportunity to deal with all different types of customers and learning to adapt to their needs. Such as, allergies, preferences, wheelchair access. Clearing tables for them to sit down, cash handling etc. I look after my daughter on a daily basis and tasks include, cooking, cleaning, dressing, potty training, taking her out, washing the dishes and clothes, shopping for the household and taking my daughter out to meet with friends and go on playdates.


What qualities do you think are important when working as a personal assistant with a disabled person? *: I think important qualities can include, being a friend, trust, making people laugh, giving advice, talking, going out, being kind, and also being able to do all the house work and caring too.


How do you think you can contribute towards the needs and the independence of a disabled person? *: I believe I can contribute by advising what to do and what not to do. Helping with all daily tasks and genuinely being a friend.


What is it about PA work which appeals to you? *: By being a personal assistant, I believe In helping, being a friend, and being able to assist when needed and on shift.
What are your hobbies/interests?: I enjoy taking my daughter to swimming lessons, street dancing lessons. I enjoy walking and being outdoors. I enjoy reading books and spending time with family


Would you consider a casual position if you are unsuccessful with this job? *: Yes


Do you drive? *: Yes

Are you a vehicle owner? *: No


Do you smoke? *: Yes


Are you able to undertake training? *: Yes


What days/nights are you able to work, or prefer to work? *: Friday evening and over night, Saturday any time, Sunday morning, afternoon and evening. Also 1 week Monday- Wednesday. 2nd week Thursday and Friday anytime apart from overning due to baby


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


If you would like to expand on the answers given above? Please use the box below.:

In what capacity do you know this person (should not be a family member)? *: work

If there is any such information you wish to provide? *: 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?: Aberdare, hirwaun



How many hours of work can you offer per week?: 16-20


Please indicate the approximate times that you are available for work throughout the week.: Monday PM/Tuesday PM/Wednesday PM/Thursday PM/Friday PM/Friday Overnight/Saturday AM/Saturday PM/Saturday Overnight/Sunday AM/Sunday PM /
Further Information: