Personal Assistant Application Form Submission 

Title (required): . 
First Name (required)
Last Name (required):  
Address 1 (required): 
Address 2: Boverton 
Town (required): Llantwit Major 
County (required): Vale of Glamorgan 
Postcode (required):
Phone number (required): 
Please enter your email address for submission confirmation. (required):  
Reference number of job being applied for (required)
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. (required): 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. (required): I currently work as a Housing Officer part-time so have experience of supporting tenants of all capabilities setting up home, maintaining their tenancies and the upkeep of their properties. Within this role, i am organised, have key communication skills and reliable. I also work with maintenance within this role, so have understanding of maintenance issues and the best contractors that can be used. My previous role was a support worker for a mental health charity, so have a good understanding of mental health conditions and how they affect an individual and how best to support them. I currently live in Llantwit Major, so also have a good understanding of the resources available. From my experiences within different social care roles, I have attributes which include patience, empathy and key communication skills. 
What qualities do you think are important when working as a personal assistant with a disabled person? (required): Communication, trustworthy, patience, Understanding, empathy and knowledge of individual conditions. 
How do you think you can contribute towards the needs and the independence of a disabled person? (required): Preserving her independence, making sure there are choices available, listening to the individual and respecting their choices. Also by being as friendly and helpful as possible. 
What is it about PA work which appeals to you? (required): Being able to help somebody in my local community with the additional time I have available. Having the ability to support somebody to maintain their independence and have a fulfilled life. 
What are your hobbies/interests?: Cooking, Dog walking, Listening to music, Exploring the local areas, Shopping, Board games 
Would you consider a casual position if you are unsuccessful with this job? (required): Yes 
Do you drive? (required): Yes 
Are you a vehicle owner?  (required): Yes 
Do you smoke? (required): No 
Are you able to undertake training? (required): Yes 
What days/nights are you able to work, or prefer to work?  (required): Wednesdays any time, 4.30 onwards Monday, Tuesday, Thursday and Friday and any time over the weekends. 
Are there any circumstances which would prevent you from providing cover or swapping a shift? (required): Yes 
If you would like to expand on the answers given above? Please use the box below.:If I have to undertake any training or day changes in my other jobs. 
Name (required):
Phone Number (required):
In what capacity do you know this person (should not be a family member)?  (required): 
In what capacity do you know this person (should not be a family member)?  (required): Worked with her previously. 
Is there is any such information you wish to disclose, relating to any cautions or convictions which will appear on your mandatory DBS check? (required): No/ 
Please provide details if necessary: 
I agree that there is nothing which would prevent me from doing this job. (required): Yes 
I consent to the above (required): 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?: Llantwit Major st athans Cowbridge 
How many hours of work can you offer per week?: 10 
Please indicate the approximate times that you are available for work throughout the week.: Monday PM/Tuesday Overnight/Wednesday AM/Wednesday PM/Friday Overnight/Saturday AM/Saturday PM/Saturday Overnight/Sunday AM/Sunday PM / 
Further Information: