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Personal Assistant Application Form Submission

Title *: Ms.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Llantwit Major
County *: Vale of Glamorgan
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 have worked in the care industry for 30 years. I have over 10 years experience in working with the elderly. I have worked in the nursing home environment as well as working in the community through an agency. My daily work routine as a care worker in the community involves personal care, food preparation, domestic duties, shopping and social visits. I have experience of use with hoists and have my manual handling passport which I gained 18 months ago and have since done a further update. I have just completed annual updates in health and safety, first aid, coshe, manual handling, pova and fire safety.

What qualities do you think are important when working as a personal assistant with a disabled person? *: Qualities such as polite, respectful, patient, respecting the persons dignity, allowing choice in decision making, fun loving and knowledgeable in manual handling.

How do you think you can contribute towards the needs and the independence of a disabled person? *: By assisting them in every day tasks so they can live a normal life as possible. By transporting them to places so they can take part in activities in the community. Being an advocate if they are not able to speak out for themselves.

What is it about PA work which appeals to you? *: I look forward to working on a 1-1 basis with people. Building a meaningful relationship with the person as you have time to get to know the person you are working with as you arent rushing from call to call. Choosing your own hours and clients, it enables you to have a good work leisure balance.

What are your hobbies/interests?: walking, photography, reading, going to cinema, crochet and knitting, dancing, festivals

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? *: would prefer to work monday to friday but would work on a saturday if needed

Are there any circumstances which would prevent you from providing cover or swapping a shift? *: No

Name *:
Job Title *:
Address *:
Phone Number *:
In what capacity do you know this person (should not be a family member)? *:
Name *:
Job Title *:
Address *:
Phone Number *:
In what capacity do you know this person (should not be a family member)? :

If there is any such information you wish to provide? *: No

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?: vale of Glamorgan

How many hours of work can you offer per week?: 35-40

Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Monday Overnight/Tuesday AM/Tuesday PM/Tuesday Overnight/Wednesday AM/Wednesday PM/Wednesday Overnight/Thursday AM/Thursday PM/Friday AM/Friday PM/Friday Overnight/Saturday AM/