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Personal Assistant Application Form Submission  

 
Title *: Mr. 

Town *: 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. *: 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. *: Im still employed as a support worker with 3 different care companies which one of them I have been with for nearly 17 yrs. Qualifications city & Guilds NVQ level 2 in Health social care. Infection control, working in Health Care Environment level 1,continence training, basic first aid, manual handling, food &Hygiene awareness, health & Awareness, child safeguarding level 2. ,medication awareness & Administration level 2. Fire Safety, Manual Handling all passport, Dementia Alzheimers Awareness, positive behaviour management, Epilepsy Awareness, health & Saftey, Adults awareness Raising, 

 
What qualities do you think are important when working as a personal assistant with a disabled person? *: Having a good communication skills, being sensitive to peoples needs, & also skills that may help them build their confidence & self-esteem. Be a good listener. 

 
How do you think you can contribute towards the needs and the independence of a disabled person? *: In the past Ive worked with so many service users .i.e brain injuries people who are in wheel chairs. Autism. DementiaAlzheimers The main things are support with making there own choices, & decisions quality of living a normal life.  

 
What is it about PA work which appeals to you? *: As above I love my job supporting people giving them the opportunity to be motivated to gain goals in life. Being independent for them selves, and getting them back into the community. 

 
What are your hobbies/interests?: Playing golf, target shooting, cycling, dog walking, cinema, tenpin bowling, 

 
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? *: Monday, Tuesday, Wednesday, Thursday.i can work nights also mon, tues,Wed,Thurs, Friday only till 12.00 noon&Sat 12.00 noon Sundays off. 

 
Are there any circumstances which would prevent you from providing cover or swapping a shift? *: No 

 
If you would like to expand on the answers given above? Please use the box below.: Over the yrs I have developed many life skills, skills such as good communication, sensitivity to peoples needs& also skills that may help others build their own confidence & Self esteem.im highly motivated. Client 100% focused person. Through my yrs in the Army I have gained experience working in a team and on my own using initiative completing tasks. Im up to date with mandatory training. Iv been always committed& dedicated to all my service users. 

 
Is there is any such information you wish to disclose, relating to any cautions or convictions which will appear on your mandatory DBS check? *: No/ 


I agree that there is nothing which would prevent me from doing this job. *: Yes 


I consent to the above *: 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, lanishensplottllanrumneySt.mellonsroathgabalfa, Ely, pentwyncyncoedllanyden,Cardiff bay.penarth. 

 
How many hours of work can you offer per week?: 40 hrs 

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