Personal Assistant Application Form Submission 

Title *:  
First Name *: 
Last Name *:  
Address 1 *:  
Address 2: 
Town *: Barry 
County *: Vale of Glamorgan 
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. *: Currently studying for my BAhons in health and social care. I have worked for multiple care agencies across Wiltshire (where I lived previously ) and have provided independent care privately to many others. I have worked as a PA to people with a variety of different health issues and needs, from learning difficulties , physical disabilities and mental health to the elderly, from sometimes just providing a few hours company to providing full support with every aspect of personal care and also palliative care. I have a recent enhanced DBS and full driving licence and wood be willing to add business to this. 
What qualities do you think are important when working as a personal assistant with a disabled person? *: I am organised and observant. I believe every person in need has the right to a high standard of care and that the person or family in need should remain in control of the decisions made around their care. I am quite outgoing and talkative with a positive outlook on life in general. I have a good sense of humour and also not easily offended. I enjoy helping others to keep as much of their independence as possible by supporting them in what ever it is they need without taking over. I have a child with a disability so have both personal and professional experience. I feel the personal experience enables me to have empathy. I am trustworthy and reliable. I am quite flexible with the hours i am able to work. I need to avoid school run hours and can’t work a Thursday evening. 
How do you think you can contribute towards the needs and the independence of a disabled person? *: I am able to supervise and support the person to enable them to be as independent as possible. I believe keeping the persons independence is of the highest importance. I am aware that as a PA I am there to support a person and not take over and do everything for them (unless this is required obviously) To me the point of care in the wider community is to enable people to remain independent and keep their sense of self for as long as humanly possible. 
What is it about PA work which appeals to you? *: I genuinely enjoy supporting people. I know how much difference keeping independence and sense of self can make to a person and I really enjoy helping to make that possible. I think being a PA is one of the best jobs when it comes to the feel good factor. Ending your day knowing you have helped a little to make someone’s day that little bit better is something that’s hard to beat and isn’t possible in many jobs. 
What are your hobbies/interests?:I like to talk. 😂 I love to cook, especially for others I enjoy walks and shopping. Love being by the sea. I read a lot and have a passion for learning new things. 
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? *: Overnight would not be impossible but would need notice. Days - Monday- Wednesday & Friday - Sunday (I cannot work Thursdays) unavailable for one hour @9am and one hour @3:45pm due to school runs 
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.: 
Name *: 
In what capacity do you know this person (should not be a family member)? *: 
In what capacity do you know this person (should not be a family member)? *: Friend 
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?: Penarth, sully, dinas Powys 
How many hours of work can you offer per week?: Varied. 
Please indicate the approximate times that you are available for work throughout the week.: 
Further Information: