Personal Assistant Application Form Submission

Title *: Miss.
First Name *:.
Last Name *: .
Address 1 *: .
Town *: Hirwaun
County *: Rct
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. *: Serenity support- support worker
What qualities do you think are important when working as a personal assistant with a disabled person? *: Being gentle, friendly and understanding, having a lot of patience
How do you think you can contribute towards the needs and the independence of a disabled person? *: Help them in anyway I possibly can
What is it about PA work which appeals to you? *: Being able to help someone and make them feel respected
What are your hobbies/interests?: Going to the gym Spending time with family
Would you consider a casual position if you are unsuccessful with this job? *: Yes
Do you drive? *: No
Are you a vehicle owner? *: No
Do you smoke? *: No
Are you able to undertake training? *: Yes
What days/nights are you able to work, or prefer to work? *: Any
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 *: .
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
How many hours of work can you offer per week?: Up to 30
Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Tuesday AM/Tuesday PM/Wednesday AM/Wednesday PM/Wednesday Overnight/Thursday AM/Thursday PM/Thursday Overnight/Friday AM/Friday PM/Friday Overnight/Saturday AM/Saturday PM/Sunday AM/Sunday PM /
Further Information: