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Personal Assistant Application Form Submission 

 
Title (required): Mrs. 

Town (required): Cardiff 
County (required): Wales 

 
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 

  
What qualities do you think are important when working as a personal assistant with a disabled person? (required): I have a son with severe autism, I know a lot about the condition. I am preparing myself for applying for my masters degree in Art Therapy. 

 
How do you think you can contribute towards the needs and the independence of a disabled person? (required): Once I create a connection with the child, I can help with improving his/ her communication skills (that does not refer to verbal communication only), developing some trust, taking turns, waiting times, length of his/ her attention and focus, anger management, sensory wise etc. 

 
What is it about PA work which appeals to you? (required): I know I can help and I will be very grateful if an opportunity will be given to me for working with the girl 😊 

 
What are your hobbies/interests?: Music, art, drawing, long walks in nature, clay/ ceramics, messy play, children behaviour in general. 

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

 
Do you drive? (required): Yes 
Are you a vehicle owner?  (required): Yes 
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): Flexible hours please 

 
Are there any circumstances which would prevent you from providing cover or swapping a shift? (required): Yes 

 
If you would like to expand on the answers given above? Please use the box below.: I can only work flexible hours, but I can let you know about my availability in advance, so we could do a rota for 1-2 months and stick to that. If you have other positions available for working with autistic children, please let me know. I want to focus on that, I know I am very good for this challenge. Thank you. 

 
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?: Cardiff/ Caerphilly 

 
How many hours of work can you offer per week?: 10-15 max, as long as flexible 

 
Please indicate the approximate times that you are available for work throughout the week.: 
Further Information: Variable rota, but decided in advance and stick to it