Personal Assistant Application Form Submission


Title *:.


First Name *: 


Last Name *: 


Address 1 *: Address 2:
Town *: abercwmboi


County *: Aberdare


Postcode *:


Phone number *: 


Please enter your email address for submission confirmation. *: 


Reference number of job being applied for *: DPC1222


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 previous professional experience as a Home Care Worker. In this role, I cared for people and children of all ages to help them live independently. My roles included personal hygiene care, day trips/travelling and general companionship. I have experience child-minding my younger brother who has Aspergers Syndrome and ADHD. This experience is relevant as I have genuine compassion for young people with learning difficulties and I am confident in managing difficult behaviour and able to remain calm in these situations. My brother is now 13 years old and although he has improved significantly, I still enjoy helping him to be more social and helping him attend his football training.


What qualities do you think are important when working as a personal assistant with a disabled person? *: I believe patience is essential when working with a disabled person and remaining calm while simultaneously being compassionate is very important. Being aware of the persons needs from the start will help me to cater my care to the specific individual.
How do you think you can contribute towards the needs and the independence of a disabled person? *: I have a naturally caring nature and love to help others. I thrive in roles that involve socialising and helping people in need. I will work with the individual and their family to ensure all of their needs are being met. I would love to help the individual in various aspects of their life such as daily routines, socialising and travel.


What is it about PA work which appeals to you? *: My previous experience in care work is something I look back on fondly. I love to work with people in need, such as children or the elderly and helping them along with encouraging their own independence is something that I am deeply passionate about.


What are your hobbies/interests?: I love literature and reading Victorian classics is a favourite activity of mine. In my spare time, I enjoy creative writing, particularly poetry and I even perform occasionally at poetry events. I enjoy mindfulness, yoga and meditation.
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? *: Any days and times of work will be considered


Are there any circumstances which would prevent you from providing cover or swapping a shift? *: Yes


If you would like to expand on the answers given above? Please use the box below.:
Name *: Job Title *:


Address *: 


Phone Number *: 


In what capacity do you know this person (should not be a family member)? *: Name *: 


Job Title *: 


Address *:Phone Number *:In what capacity do you know this person (should not be a family member)? *: 


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?: Aberdare, Merthyr Tydfil, Mountain Ash and surrounding areas
How many hours of work

an you offer per week?: up to 20


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: