107VOG

Personal Assistant Application Form Submission

Title *: Mr.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Barry
County *: Vale of Glamorgan
Postcode *: CF62
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 Health and Social Care level 1-2-3 I have over 7 years experience in the care sector.
What qualities do you think are important when working as a personal assistant with a disabled person? *: I have person centre care values and always put the client first before myself. Always have a eye for attention to detail.
How do you think you can contribute towards the needs and the independence of a disabled person? *: Listen to the client and let them do a task they can do before assisting over their independence. As little things can go a long way.
What is it about PA work which appeals to you? *: I have always wanted to be a PA for a long time and it gives me the satisfaction that I can be with a client to assist them to their needs.
What are your hobbies/interests?: I enjoy doing walks down the beach Swimming / surfing Trail walks even shopping
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? *: Either
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? *: 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?: Vale of Glamorgan South Glamorgan Bridgend Cardiff
How many hours of work can you offer per week?: 30
Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Monday Overnight/Tuesday AM/Tuesday PM/Tuesday Overnight/Wednesday AM/Wednesday PM/Wednesday Overnight/Thursday AM/Thursday PM/Thursday Overnight/Friday AM/Friday PM/Friday Overnight/Saturday AM/Saturday PM/Saturday Overnight/Sunday AM/Sunday PM /Sunday Overnight/
Further Information:

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