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Personal Assistant Application Form Submission

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

Reference number of job being applied for *:

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 worked on and off in the caring profession for 46years.I qualified as a nurse in 1977 and undertook this role for the next 6 years, then left to have my family. After having 2 children I moved to Cardiff in 1990 and started working for Cardiff County Council with the Disabilities Team in 1993.I have worked for nine families up until this point all with varying forms of disabilities such as cerebral palsy, autism, down’s syndrome and seizures. I am working with a family now, who I have been with for over 10 years.

What qualities do you think are important when working as a personal assistant with a disabled person? *: All this experience shows that I have excellent interpersonal skills with lots of patience and compassion. I think it is important to note that I would not have been working in this profession for so many years had I not found it as rewarding and fulfilling as I do. Compassion and understanding I feel are very important to help the client feel confident, comfortable and relaxed in my care.These qualities would also show that I am invested in the lives of those I care for.

How do you think you can contribute towards the needs and the independence of a disabled person? *: By supporting the person in question, by taking them out shopping, for coffee and lunch or to meet their friends. In addition to this, helping them interact in the community, assisting them with hobbies and also their everyday activities and routine, such as cooking and cleaning.

What is it about PA work which appeals to you? *: Caring and looking after people has always come second nature to me. I find it very rewarding and fulfilling. In addition to this, I am able to give back to the community, as I have been very lucky to have great carers for my son with disabilities.

What are your hobbies/interests?: I absolutely love to cook, bake, read books, watch TV , gardening (when it’s warm!) I also love to spend time with my family.

Would you consider a casual position if you are unsuccessful with this job? *: No

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? *: Open to discussion

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.:
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?: Fairwater, Llanishen, Roath Heath Pentrebane Radyr

How many hours of work can you offer per week?: 25hours

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