116VOG

Personal Assistant Application Form Submission

Title *: Miss.
First Name *:
Last Name *: Address : Gibbonsdown
Town *: Barry
County *: Vale of glamorgan
Postcode *: CF63
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 worked in care on and off for approximately 20 years. I have worked in a care home environment and also community care. I am also qualified to NVQ Level 3 in Health and Social Care.
What qualities do you think are important when working as a personal assistant with a disabled person? *: To be compassionate, caring and confidential. Help to maintain independence.
How do you think you can contribute towards the needs and the independence of a disabled person? *: I think that it is very important to listen to what your employer wants and needs. Never assume that you already know.
What is it about PA work which appeals to you? *: I enjoy building a relationship one to one. I think that having consistency for the elderly is important.
What are your hobbies/interests?: I enjoy spending time with my grandmother, walking, a little t.v.
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? *: Yes
Are you able to undertake training? *: Yes
What days/nights are you able to work, or prefer to work? *: Mon-Fri days and occasional weekends
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.: With regards to references, I can provide upon request. This is due to my last two positions held are no longer in business.

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
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/Tuesday AM/Wednesday AM/Thursday AM/Friday AM/
Further Information: Occasional weekends

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119VOG

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