REF:183RCT Personal Assistant Application Form Submission Title *: First Name *: Last Name *: Address 1 *: Town *:County *:Treorchy 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 already work for dewis with 2 people. And have done this job caring for 12years mencap first then cartrefi cymru and innovate trust my imployer know but am looking to reduce my hours with them What qualities do you think are important when working as a personal assistant with a disabled person? *: caring , honest ,happy and treating them like i would want to be treated myself How do you think you can contribute towards the needs and the independence of a disabled person? *: being relyable hands on and very supportedWhat is it about PA work which appeals to you? *: making sure they have a good time and are happy either out and about doing activety or at home doing hobbiesWhat are your hobbies/interests?: gym , swimming , bowling , going to the cinama , driving to the sea side , holiday ,shows 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? *: YesWhat days/nights are you able to work, or prefer to work? *: i am very flexableAre 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 *: Job Title *: Address *: Phone Number *: In what capacity do you know this person (should not be a family member)? *: Name *: steve trehane Job Title *:r Address *: In what capacity do you know this person rson (should not be a family member)? *: 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).: YesWhat geographical area’s are you able to cover?: all r.c.t and futher with more hrsHow many hours of work can you offer per week?: 3hrs upto 20hrsPlease 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/Sunday Overnight/Further Information: