Personal Assistant Application Form Submission


Title *: .
First Name *: 
Last Name *:
Address 1 *:
Address 2:
Town *: 
County *: Llantrisant
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. *: I am a reliable caring and understanding person who have many years experience in customer service and helping people and i think although i have not got any carer experience i have a lot of life skills i have learned that would be valuable and enable me to be the best carer i can be
What qualities do you think are important when working as a personal assistant with a disabled person? *: I think Patience is really important also to be Caring Confident and Calm and a good Listener
How do you think you can contribute towards the needs and the independence of a disabled person? *: I am a outgoing enthusiastic caring person who would be good company and would encourage the service user to be able to live the best possible life and i would be happy to support them any way i could
What is it about PA work which appeals to you? *: I love interacting with people and i take a real enjoyment helping people and making a difference in there life.
What are your hobbies/interests?: I love being outdoors walking or taking my kids to the park or leisure centre
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? *: fully flexible on Saturday and Sunday any time. can also do evenings after school
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.: due to child care commitments i am fully flexible weekend but weekdays after 4

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?: llantrisant , cowbridge and llanharran and surrouding areas
How many hours of work can you offer per week?: 16
Please indicate the approximate times that you are available for work throughout the week.: Friday Overnight/Saturday AM/Saturday PM/Saturday Overnight/Sunday AM/Sunday PM /Sunday Overnight/
Further Information: