Personal Assistant Application Form Submission


Title *: Mrs.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Penarth
County *: South Glamorgan
Postcode *: CF64 
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 am currently self employed as a personal assistant to an 88 year old lady for the past 15 years, who has some mobility issues. I currently carry out cleaning, washing, shopping, prepare meals, company & take her on local outings for meals & coffee. I also work as a personal assistant to a 91 year old man who also has mobility issues providing house help & company. I also work as a personal assistant for an 85 year old active lady, conducting household duties, driving to appointments & shopping. I also have experience of caring for an elderly relative who had severe dementia & was bed bound.
What qualities do you think are important when working as a personal assistant with a disabled person? *: Understanding, caring, patience, reliability, encouraging, tolerance, maintaining a personal relationship, good hygiene practices, being supportive, honesty
How do you think you can contribute towards the needs and the independence of a disabled person? *: Being supportive & encouraging. I like to help my people to do things which improve those persons quality of life. I am adaptable & flexible
What is it about PA work which appeals to you? *: I take satisfaction from encouraging the individual to improve their quality of life. I enjoy their company, talking to them & having a laugh. I like to make them smile. I like to know that when I leave I have provided a good service & like to know I have left them well cared for & happy.
What are your hobbies/interests?: I enjoy walking, cycling & gym to maintain fitness. I love music, especially live music venues, socialising & dancing. I enjoy eating out. I enjoy travelling & camping.
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? *: I can work flexibly monday to sunday around my other personal assistant commitments
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.:

Is there is any such information you wish to disclose, relating to any cautions or convictions which will appear on your mandatory DBS check? *: Yes/
Please provide details if necessary: I currently possess 2 DBS checks by other agencies
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?: Penarth, Llandough, Dinas Powys, Sully
How many hours of work can you offer per week?: 16 flexible
Please indicate the approximate times that you are available for work throughout the week.: Monday PM/Monday Overnight/Wednesday PM/Wednesday Overnight/Friday AM/Friday PM/Sunday AM/
Further Information: