Personal Assistant Application Form Submission


Title *:.
First Name *: 
Last Name *: 
Address 1 *: 
Address 2: 
Town *: Barry
County *:
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 experience in many fields of work, I have worked for a care company which was called green banks at the time now I believe it’s allied care. Duties included personal care , taking clients shopping , out for walks . Food , excercise . Shopping, cooking food . Cleaning and general company . I’ve also worked for Lloyds bank doing business banking . I have 2 daughters aged 20 and 16 so am not tied up to working around them as Such anymore, I have worked as a pharmacy dispenser for the last 8 years and currently working for Iceland doing online picking . As you can see I have a wide variety of experience in different work
What qualities do you think are important when working as a personal assistant with a disabled person? *: Understanding , care , compassion and patience are very important on this type of work
How do you think you can contribute towards the needs and the independence of a disabled person? *: I’m bubbly , chatty , fun and fair. I love the fact that the client likes to sing and watch Disney films, this is a huge love of mine (well music especially) and feel I could really help this young person to be herself and enjoy life to its best
What is it about PA work which appeals to you? *: Helping others live a decent life and seeing people smile really makes me happy
What are your hobbies/interests?: Walking . Horse riding , swimming , walking dogs , fashion , food
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? *: Mainly days (any )
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.:
Name *: 
Phone Number *:
In what capacity do you know this person (should not be a family member)? *: 
Name *: 
In what capacity do you know this person (should not be a family member)? *: friend
Is there is any such information you wish to disclose, relating to any cautions or convictions which will appear on your mandatory DBS check? *: 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?: All of vale of glamorgan
How many hours of work can you offer per week?: Not limited as many as possible
Please 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 am very flexible with Hours I can work , would prefer not to work overnight but would if desperately needed to help out