Personal Assistant Application Form Submission 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): Home care worker for 2 years, registered with social care wales. What qualities do you think are important when working as a personal assistant with a disabled person? (required): Caring and understanding, good listener and respectful. How do you think you can contribute towards the needs and the independence of a disabled person? (required): Im very understand and a good listener, respectful towards peoples needs and helping them live a full life What is it about PA work which appeals to you? (required): I love helping others and find pa work very rewarding What are your hobbies/interests?: I have children so I enjoy doing activities with them and socialising with friends Would you consider a casual position if you are unsuccessful with this job? (required): Yes Do you speak any other languages? (required): No Do you drive? (required): Yes Are you a vehicle owner? (required): Yes Do you smoke? (required): Yes Are you able to undertake training? (required): Yes What days/nights are you able to work, or prefer to work? (required): Day shifts no night shifts on a weekend Are there any circumstances which would prevent you from providing cover or swapping a shift? (required): No If you would like to expand on the answers given above? Please use the box below.: Do you have portable DBS (which has been paid for and renewed for the current year)? (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/ Please provide details if necessary: 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?: Maerdy, ferndale, aberdare Mountin ash How many hours of work can you offer per week? (required): 16 Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Tuesday AM/Wednesday AM/Thursday AM/Friday AM/Friday Overnight/ Further Information: