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Personal Assistant Application Form Submission


Title *: Ms.
First Name *:
Last Name *:
Address 1 *:
Address 2: Danescourt
Town *: Cardiff
County *: Cardiff
Postcode *:
Phone number *:
Please enter your email address for submission confirmation. *:
Reference number of job being applied for *:


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. *: Right at Home, caring and supporting vunerable people in their own home. Ty Llandaff, personal care and support in Residential setting.


What qualities do you think are important when working as a personal assistant with a disabled person? *: Kindness, empathy, patience and enthusiasm are a must. Support and encouragement to enable as much independence as possible.


How do you think you can contribute towards the needs and the independence of a disabled person? *: I have professional experience and personal experience of supporting people with special needs. I concentrate on the positives and encourage people to be the best they can be.


What is it about PA work which appeals to you? *: Helping vunerable adults to achieve their goals is very rewarding. Getting to know people from different back grounds and the lives they lead is so interesting. Being a part of what they like to do and what they would like to achieve, for me is giving a little something to my community.


What are your hobbies/interests?: I am training in Hairdressing in Cardiff & Vale College, it is something I have always wanted to do. I have a grown up family at home but it is my 3 cats and dog that are constantly after my attention. I enjoy cooking, crochetting , knitting and meeting new people.


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? *: Yes


Are you able to undertake training? *: Yes


What days/nights are you able to work, or prefer to work? *: Monday all day, Tuesday am, Wednesday evening, Thursday all day, Saturday pm, Sunday all day


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.: Only if my College timetable changes which is unlikely.


Name *:
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? *: 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-Llandaff, Canton, Fairwater, Gabalfa, Radyr, St Fagans, Whitchurch


How many hours of work can you offer per week?: Up to 16 hours


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