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Personal Assistant Application Form Submission 

Title: MR 

Town (required): CARDIFF

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 am a compassionate health care work with vast experience in health sector , i cherish team work and i acn also work indepentently, while at work dignity and confedentiality of the servives user are protected 

What qualities do you think are important when working as a personal assistant with a disabled person? (required): Disables individual may have unique need and challenge that require patience and undestanding, its important to listen and adapt to their need and preference 

How do you think you can contribute towards the needs and the independence of a disabled person? (required): Prove practical assistance with thier daily task 

What is it about PA work which appeals to you? (required): Helping individual access resouces and services may be difficuit to obtain independently 

What are your hobbies/interests?:reading 

Would you consider a casual position if you are unsuccessful with this job? (required): Yes 

Do you speak any other languages? (required): YES 

Do you drive? (required): Yes 
Are you a vehicle owner?  (required): No 
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): I CAN WORK ALL NIGHT, BUT FOR DAY TUESDAY AND THUSDAY I CANT WORK 

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): 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): Yes/ 

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?: 

How many hours of work can you offer per week? (required): I CAN WORK FOR 60 HOURS IF AM GIVEN THE OPPORTUNITY 

Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Monday Overnight/Tuesday Overnight/Wednesday AM/Wednesday PM/Wednesday Overnight/Thursday AM/Thursday Overnight/Friday AM/Friday PM/Friday Overnight/Saturday AM/Saturday PM/Saturday Overnight/Sunday AM/Sunday PM /Sunday Overnight/