Personal Assistant Application Form Submission

Title *: Ms.
First Name *: 
Last Name *: 
Address 1 *: 
Address 2: Brackla
Town *: Bridgend
County *: Glamorgan
Postcode *: 
Phone number *: 
Please enter your email address for submission confirmation. *: 

Reference number of job being applied for *: 

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 worked as a physiotherapist in the NHS for 35 years, spending the last 20 years of my career at Morriston Hospital Swansea. I treated many patients with dementia during this time who had been admitted to hospital for other medical reasons e.g. fractures.

What qualities do you think are important when working as a personal assistant with a disabled person? *: A personal assistant needs to be caring, reliable and considerate. Good listening and communication skills are essential as they should enable the PA to gain a realistic understanding of the clients needs and goals.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I think it is important to enable the client to achieve his goals and ensure that all care/support is centred around the clients needs. For this particular client I would enjoy accompanying him on walks as I am a keen rambler myself and a member of the Vale of Glamorgan Ramblers. I would also really enjoy assisting the client with his gardening.

What is it about PA work which appeals to you? *: I feel comfortable working in a caring capacity as my previous work in the NHS has been in this area. It is a pleasure to enable clients to achieve their goals and hopefully as a result improve their quality of life.

What are your hobbies/interests?: Walking, reading, allotment gardening and creating dishes from the produce. Spending time outdoors in nature reserves and wildlife centres and spending time with the family.

Would you consider a casual position if you are unsuccessful with this job? *: No
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? *: Prefer to work days, can be very flexible with the days.
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.: No

If there is any such information you wish to provide? *: 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?:
How many hours of work can you offer per week?:

Please indicate the approximate times that you are available for work throughout the week.:

Further Information: