Personal Assistant Application Form Submission


Title *: Miss.


First Name *: 


Last Name *: 


Address 1 *: Address 2: Town *: Cardiff


County *: S Wales


Postcode *: 


Phone number *: 


Please enter your email address for submission confirmation. *:Reference number of job being applied for *: Cdp1320


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 an employer of Dimensions, working with Special needs. Employed for 13 yrs. Right at Home, working with all aspects of care with Elderly males and females. During my time with both Agencies, I gained vast experiences and training relevant to each individuals I have worked with. My mandatory training is up to date, and I have recently obtained my level 3 in Health and Social Care.
What qualities do you think are important when working as a personal assistant with a disabled person? *: A persons individual care, support and needs are first, and foremost. Adhering to any care plan set for the person. Having an empathetic approach to any situation. Working with the families issues. (good or bad). Basically getting to know the individual in Question is Important.


How do you think you can contribute towards the needs and the independence of a disabled person? *: Being disabled can bring isolation and solitude. Not being able to do simple every day tasks can be difficult,depending on the disability. Having many years of working with Special needs and disability. I have gained good understanding and experience working with individuals.


What is it about PA work which appeals to you? *: Making a difference however big or small it may be. A successful task is very rewarding. Helping to fulfill a need thats a long time waiting. Encouraging to face each day with difference.


What are your hobbies/interests?: My hobbies are working with flowers. Weddings etc. Reading Walking Craftwork


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? *: I am initially looking for live in, or overnight care. If not, Monday to fri. Every other weekend.
Are there any circumstances which would prevent you from providing cover or swapping a shift? *: Yes


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)? *: Manager
Name *: 


Job Title *: 


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


If there is any such information you wish to provide? *: No


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?: Rhiwbina. Llanishen. Whitchurch any cf 14 area.


How many hours of work can you offer per week?: 30 hrs


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