CDF41

Personal Assistant Application Form Submission 

 
Title: Mrs 

Address 2: Roath 
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 have been taking care of my elderly Father for many years now who has COPD and severe Mobility issues. This has given me a huge insight into his life and how to help care for him During my working career as an operations Manager for a utilities company I learnt many transferable skills such as how to multi task, how to deal with people and how to communicate. 

 
What qualities do you think are important when working as a personal assistant with a disabled person? (required): How to treat people with dignity and respect. To help them be as independent as possible and to achieve their goals. 

 
How do you think you can contribute towards the needs and the independence of a disabled person? (required): To ask them how they would like to be treated. To talk to them and listen. 

 
What is it about PA work which appeals to you? (required): I enjoy working with people and being able to help them. 

 
What are your hobbies/interests?: Meeting people Cinema Walking Tv films cinema Coffee ! Going for food Music 

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

 
Do you speak any other languages? (required): No 

 
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): Mon -Fri 0930-1400 

 
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.: Evening and school holidays 

 
Do you have portable DBS (which has been paid for and renewed for the current year)? (required): No/ 

 
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? (required): 8 

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