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Reference #
Status Complete
Title Ms.
First Name 
Last Name
Address 1
Address 2 Pentwyn
Town Cardiff
County S.Wales
Post Code
Email Address
Job reference number
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 BlueBirds Care
Caring, talkative, loyal and trustworthy. A people person
What qualities do you think are important when working as a personal assistant with a disabled person? To care and look after them to the full potential and cover whatever they need.
How do you think you can contribute towards the needs and the independence of a disabled person? same as above
What is it about PA work which appeals to you? To have one on one contact with the individual and give them everything they need.
What are your hobbies/interests? Watching TV, cinema, eating out
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? I am flexible as this would be an additional job as I do mobile hair work for myself.
Are there any circumstances which would prevent you from providing cover or swapping a shift? No
Would you like to expand on the answers given above? Please use the box below. I live in Pentwyn so the areas I have given are not too far to go and I know that part of Cardiff.
In what capacity do you know this person (should not be a family member)?
In what capacity do you know this person (should not be a family member)?
Rehabilitation of Offenders Act 1975 * Within the nature of the work for which you are applying this position is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1975 (Exemptions Order). Applicants are therefore not entitled to withhold information about convictions which for other purposes are ‘spent’ under the provisions of this Act. In the event of employment, any failure to disclose such convictions could result in dismissal. Information given is confidential and will only be considered for the purposes of the application. If there is any such information you wish to provide? Yes
Please provide details if necessary A row with my ex husband over child maintenance in 2012. which ended in me slapping him and he called the police and I was given a caution.
I agree that there is nothing which would prevent me from doing this job. Yes
The organisation will hold your data on file for twelve months after the end of the relevant recruitment process if you provide consent. The purpose of retaining your data with your consent is to allow you to apply easily for other jobs we may have available. At the end of the twelve months period you will be required to complete a new application form in order to remain on our system. You may withdraw your consent for us to hold your data at any time after the initial recruitment process is completed. I consent for my personal data to be held and agree that Dewis CIL may keep this application form on file for twelve months. It may be used for future prospective employers. I understand that you will contact me in due course should any such person make themselves known to you. 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? Pentwyn, Llanedeyrn, Rumney, Llanrumney, Trowbridge
How many hours of work can you offer per week? Again flexible as long as I know the rota would be the same every week so I could do some hair in between
Last Update 2019-05-02 05:01:05