462RCT Personal Assistant Application Form Submission Title (required): Mrs.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): 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. (required): For 4 years I supported an 83 year gentleman with severe dementia, who has sally recently passed away. My duties included :Personal care, shopping trips and days out. Preparing meals, general house work, laundry, socializing and meeting people in various groups.What qualities do you think are important when working as a personal assistant with a disabled person? (required): Patience, empathy, communication skills, understanding and calm nature. How do you think you can contribute towards the needs and the independence of a disabled person? (required): I am physically fit and would encourage exercise which would benefit not only physical but the mental health also. Encourage socializing in various fields to enhance independence and integration to feel part of the community.What is it about PA work which appeals to you? (required): I feel that I have the qualities, experience and the attitude to make a difference to someones independence and wellbeing, enabling the individual to get the most out of everyday. What are your hobbies/interests?: I enjoy shopping and getting out and about, I am a member of the local walking club, where we join and explore the local countryside. I enjoy doing crosswords and puzzles I also like to spend time socializing with family and friends. Would you consider a casual position if you are unsuccessful with this job? (required): YesDo you drive? (required): YesAre you a vehicle owner? (required): YesDo you smoke? (required): NoAre you able to undertake training? (required): YesWhat days/nights are you able to work, or prefer to work? (required): AnyAre there any circumstances which would prevent you from providing cover or swapping a shift? (required): NoIf 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): YesI consent to the above (required): 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?: All the Rhondda, Talbot Green and anywhere in-between including Gilfach Goch, Tonyrefail. How many hours of work can you offer per week?: 20Please 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/Thursday AM/Thursday PM/Friday AM/Friday PM/Saturday AM/Saturday PM/Sunday AM/Sunday PM /Further Information: I would be prepared to do the odd overnight but not on a regular basis.