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Personal Assistant Application Form Submission 

 
Title (required): Mr. 

Town (required): Cardiff 
County (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 currently work as a personal assistant to my little brother who is Autstic. I have been looking after him for 8 years and have a gained a lot of experience working with people with special needs. I know how important it is for the days to be routined and understand that with the correct help they can do anything they want. 

What qualities do you think are important when working as a personal assistant with a disabled person? (required): Patient, kind, understanding and full of joy. 

 
How do you think you can contribute towards the needs and the independence of a disabled person? (required): I can support with any need they might have and daily routines they follow. I have experience with task cards. I am patient and have experience with special needs. I can support with motility and can insure safety at all times. 

 
What is it about PA work which appeals to you? (required): PA work is rewarding for me. To help a person that is full of potential is a joy for me. Having an autistic brother i am fascinated by the potential they have. 

 
What are your hobbies/interests?: I like to take long walks, play football and watch TV series. 

 
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): Weekends and evenings 

 
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 am not available during weekdays 

 
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 

 
How many hours of work can you offer per week?: 20 

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