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Personal Assistant Application Form Submission 

 
Title (required): Mr. 

Town (required): Porth 

 
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'm a degree holder in Sociology and Anthropology, I am a great Driver with over 12 years experience, I am a Physical therapist, and a good sportsman, I love to play some outdoor and indoor activities like Judo, volleyball, snooker and Scrabble. I am compassionate, passionate, proactive, strong and very Funful going person, I love good meal and cinemas. I hope to give in my best using positive practical approach. I am hopeful that my Characteristics will be a great match for what will make me serve you as good personal assistant 

 
What qualities do you think are important when working as a personal assistant with a disabled person? (required): 1. I have to be compassionate 2. Strong and proactive 3. Selfless and willing to work under stress Or pressure 4. Cheerful and full of positive vipes 5.ready to keep my employer away from danger always 6. First hand information of all safety rules and emergency exit at all times 7. Accommodative and patient 

 
How do you think you can contribute towards the needs and the independence of a disabled person? (required): 1. By being attentive to there needs or request 2. Respect there privacy and choices 3. Using positive words on them e.g You are the strongest, the smartest and making them see themselves not limited by there present conditions, Compliment there looks 4. Reminding them of Appointments 5. Services using proactive methods 

 
What is it about PA work which appeals to you? (required): Service and responsibility Confidentiality of Service Private Working environment Creativity and Friendship It is also a learning ground for me 

 
What are your hobbies/interests?: Sporting activities such as Judo, Volleyball, snooker and scrabble Driving, Outdoor activities and Good meal 

 
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): Day and night 

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

 
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/ 

 
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?: Cardiff, Treforest, pontypridd, Newport, Porth, Aberdare, Bridgend 

 
How many hours of work can you offer per week?: 60 and above 

 
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/Thursday Overnight/Friday AM/Friday PM/Friday Overnight/Saturday AM/Saturday PM/Saturday Overnight/Sunday AM/Sunday PM /Sunday Overnight/ 

 
Further Information: I am eager to give my Service, I hope to be given a chance. I am willing to start immediately, distance is not a challenge, I can be at my point of work as quickly as possible