Personal Assistant Application Form Submission


Title *: ..
First Name *: 
Last Name *: 
Address 1 *: 
Town *: Tonypandy
County *: Rhondda Cynon Taff
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 previous experience in the care sector, I have worked for 2 big care companies before, my job roles were bathing, cooking, cleaning, assisting at meal times, shopping, taking people out into the community.
What qualities do you think are important when working as a personal assistant with a disabled person? *: I think you need to be a kind, caring understanding patient person when working as a personal assistant.
How do you think you can contribute towards the needs and the independence of a disabled person? *: I thoroughly enjoy helping others, I’m a very warm easy going person, I get along well with others, I’m reliable trustworthy.
What is it about PA work which appeals to you? *: I like to help people with their day to day life, if I can give someone a better easier way of life then that appeals to me very much.
What are your hobbies/interests?: I enjoy being out in the community, helping and meeting new people, I enjoy fun activities such as bowling and cinema.
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? *: Wednesday, Thursday, Friday, Saturday days preferably as I have 2 children
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.: I’ve always enjoyed helping others, it’s something I’ve wanted to do since I was little, I have my NVQ level 3 in health & social care. I’ve worked with a wide variety of people with different needs, so I have experience in different circumstances.
Name *: 
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?: Rhondda Cynon Taff
How many hours of work can you offer per week?: 22.5
Please indicate the approximate times that you are available for work throughout the week.: Wednesday AM/Thursday AM/Friday AM/Saturday AM/
Further Information: