Personal Assistant Application Form Submission 

Title *:. 
First Name *:y 
Last Name *:Address 1 *: Address 2:l 
Town *: Canton 
County *: Wales 
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. *: I have recently been made redundant from a Purchasing Manager position due to Covid 19 and don't have professional experience working as a PA but I do have experience helping to care for an elderly relative who suffered a stroke and experience with a friend who has cerebral palsy, I often accompany her with social activities and feel that I would be a perfect fit for this role. 
What qualities do you think are important when working as a personal assistant with a disabled person? *: I think its important to be a kind, patient, compassionate and adaptable individual with excellent time keeping and communication skills. 
How do you think you can contribute towards the needs and the independence of a disabled person? *: I am a very patient friendly individual, I am an excellent motivator and adapt well to different personalities. Im very outgoing and love a range of activities. 
What is it about PA work which appeals to you? *: I love meeting people and am very sociable I would love to work in a position that is helping other individuals. 
What are your hobbies/interests?:In my spare time i enjoy a range of activities including Hiking, yoga, cooking, Reading, gardening and extreme sports. I also enjoy charity work and during the past 12 months I have voluntereed for Operation Christmas Child, Barnardos, The British Red Cross, Collecting prescriptions and delivering care packages during the Covid 19 Pandemic. 
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? *: Any days 
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 *: 
In what capacity do you know this person (should not be a family member)? *: Name *:  
Phone Number *:  
In what capacity do you know this person (should not be a family member)? *:   
Is there is any such information you wish to disclose, relating to any cautions or convictions which will appear on your mandatory DBS check? *: 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?: Cardiff - Barry 
How many hours of work can you offer per week?: 30 
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/Sunday AM/ 
Further Information: