Personal Assistant Application Form Submission


Title (required): Mrs.
First Name (required): 
Last Name (required):
Address 1 (required): 
Address 2:
Town (required): Sully
County (required): Vale of Glamorgan
Postcode (required): CF64
Phone number (required): 
Please enter your email address for submission confirmation. (required): 
Reference number of job being applied for (required): VOG672
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 have life experience ! I love to help people
What qualities do you think are important when working as a personal assistant with a disabled person? (required): patience and understanding every individual
How do you think you can contribute towards the needs and the independence of a disabled person? (required): I know I am capable of assisting your client for the needs required
What is it about PA work which appeals to you? (required): I like to help people out
What are your hobbies/interests?: dog walking cooking
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): I have a partime job and my hours there are 1-5 pm so anytime around then
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.: my current work commitments would prevent me from doing afternoons

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): Yes/
Please provide details if necessary: one of my children has a record which may show up on my DBS
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?: around sully/penarth/barry/dinas powis/wenvoe
How many hours of work can you offer per week?: up to 10
Please indicate the approximate times that you are available for work throughout the week.: Monday Overnight/Tuesday AM/Tuesday Overnight/Wednesday AM/Thursday AM/Friday AM/Saturday AM/Saturday PM/Sunday AM/Sunday PM /
Further Information: