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Personal Assistant Application Form Submission


Title *: Mr.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: Cardiff
County *: South Glamorgan
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. *: Im a fluent Welsh speaker. Have worked in various call centres where conversing with people is a must so can help on the companionship side. Willingness to learn and train for the role.


What qualities do you think are important when working as a personal assistant with a disabled person? *: Non-judgemental, empathatic, patience, friendliness, good speaking and listening skills.


How do you think you can contribute towards the needs and the independence of a disabled person? *: By assisting with the needs of another person in the way that they wish to be treated without being judgemental.


What is it about PA work which appeals to you? *: Generally empathetic and believe everybody deserves equal opportunity. Helping those with disabilities can help contribute to this.


What are your hobbies/interests?: Music (I am a songwriter myself), literature, films the arts in general. pOLITICS.


Would you consider a casual position if you are unsuccessful with this job? *: Yes


Do you drive? *: No


Are you a vehicle owner? *: No


Do you smoke? *: No


Are you able to undertake training? *: Yes


What days/nights are you able to work, or prefer to work? *: All fays are fine but preference for working evenings/nights


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


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? *: Yes


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 all around


How many hours of work can you offer per week?: 20


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