266RCT Personal Assistant Personal Assistant Application Form Submission Title *: .First Name *: Last Name *:Address 1 *:Address 2:Town *: County *: LlantrisantPostcode *: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. *: YesPlease 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 beWhat 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 ListenerHow 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 couldWhat 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 centreWould you consider a casual position if you are unsuccessful with this job? *: YesDo you drive? *: YesAre you a vehicle owner? *: YesDo you smoke? *: NoAre you able to undertake training? *: YesWhat days/nights are you able to work, or prefer to work? *: fully flexible on Saturday and Sunday any time. can also do evenings after schoolAre there any circumstances which would prevent you from providing cover or swapping a shift? *: YesIf 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 4Phone 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. *: YesI consent to the above *: YesI agree that the information I provide will be posted to the Dewis CIL PA noticeboard (all personal information will be withheld).: YesWhat geographical area’s are you able to cover?: llantrisant , cowbridge and llanharran and surrouding areasHow many hours of work can you offer per week?: 16Please 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: