Personal Assistant Application Form Submission


Title (required): Mrs.
First Name (required):
Last Name (required):
Address 1 (required):
Address 2:
Town (required): Pontyclun
County (required): Rct
Postcode (required):
Phone number (required):
Please enter your email address for submission confirmation. (required):
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 previously worked in 2 different nursing homes the 1st was Llantrisant nursing home the 2nd was The Manor house in Cowbridge I have also worked in the community as a carer, I have experience of personal care , sorting out medication, helping with household bills and chores , accessing the community to do day to day activities.
What qualities do you think are important when working as a personal assistant with a disabled person? (required): I have patience , I’m hardworking , i have experience with different disabilities .
How do you think you can contribute towards the needs and the independence of a disabled person? (required): I’m friendly, outgoing, willing to learn off the disabled person their wants and needs, I can drive and own my own car, I’m an animal lover.
What is it about PA work which appeals to you? (required): I want to help make a difference and help someone gain their independence.
What are your hobbies/interests?: I like walking , swimming, reading , cooking mostly cake making more Mary Berry than Jamie Oliver !!
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): Monday, Wednesday, Friday, Saturday days
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.:
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): No/
Please provide details if necessary:
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?: Area local to Pontyclun
How many hours of work can you offer per week?: 10 hours
Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Wednesday AM/Wednesday PM/Friday AM/Friday PM/Saturday AM/Saturday PM/
Further Information: