522RCT Personal Assistant Application Form Submission Title (required): Mrs.Town (required): FerndaleI 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): YesPlease 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 have worked as a PA also in nursing homes and worked as a mental health support worker What qualities do you think are important when working as a personal assistant with a disabled person? (required): Honesty, reliability, confidentiality, communication. How do you think you can contribute towards the needs and the independence of a disabled person? (required): Seek to support, not control, Establish a trust, Learn from each other and adapt to their needs, Allow choice about friends and lifestyle not take control.What is it about PA work which appeals to you? (required): I enjoy helping others and making a positive difference in their lives. Ive always been interested in work that involves helping others and making a positive impact. I enjoy being an active member of my community and helping people.What are your hobbies/interests?: Reading, walking and history.Would you consider a casual position if you are unsuccessful with this job? (required): YesDo you speak any other languages? (required): NoDo you drive? (required): YesAre you a vehicle owner? (required): YesDo you smoke? (required): YesAre you able to undertake training? (required): YesWhat days/nights are you able to work, or prefer to work? (required): Monday to Friday anytime during the day or night. Are there any circumstances which would prevent you from providing cover or swapping a shift? (required): YesIf 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): Yes/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): YesI consent to the above (required): YesI 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?: How many hours of work can you offer per week? (required): 12Please indicate the approximate times that you are available for work throughout the week.: Further Information: