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Personal Assistant Application Form Submission

Title *: Mrs.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Cardiff
County *: Cardiff
Postcode *:
Phone number *:
Please enter your email address for submission confirmation. *:

Reference number of job being applied for *: 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. *: I have been caring for my in laws for the last 20 years. recently they have been suffering with lots of medical issues like diabetes and hypertension.

What qualities do you think are important when working as a personal assistant with a disabled person? *: I speak in English, Urdu and Punjabi. I have caring for my in laws who are elderly and suffering with different illnesses. I am patient and calm, I organise my responsibilities with time management.

How do you think you can contribute towards the needs and the independence of a disabled person? *: I can support them by providing food at times, wash their clothes, cleaning their room, change bedding and talk to them whenever they need me.

What is it about PA work which appeals to you? *: I speak in Urdu, Punjabi and English. I like working in the community to help others. this will give me an opportunity to help others.

What are your hobbies/interests?: gardening and cooking are my hobbies.

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? *: 2/3 hours per week

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

Job Title *:
Address *:
Phone Number *:
In what capacity do you know this person (should not be a family member)? *:

Name *:
Job Title *:
Address *:
Phone Number *:
In what capacity do you know this person (should not be a family member)? *:

If there is any such information you wish to provide? *: Yes

Please provide details if necessary:

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?: Anywhere in Cardiff

How many hours of work can you offer per week?: 2-3 hours per week