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Personal Assistant Application Form Submission 

 
Title (required): Miss. 

Town (required): Cardiff 

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. (required): 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. (required): I currently work at Burger King Culverhouse Cross as a Shift Manager/Supervisor. My role at Burger King includes training and supervising staff that tend to be aged between 16-21. My role also includes shift running, cash handling, maintaining the cleanliness of the store, key-holder and supervising the staff ensuring all company standards and procedures are met. 

 
What qualities do you think are important when working as a personal assistant with a disabled person? (required): I feel that adaptability is an important quality to have in order to meet the required needs of an individual, along with being attentive. Most importantly, I believe that you must need a genuine passion for looking after others and their interests. 

 
How do you think you can contribute towards the needs and the independence of a disabled person? (required): I can contribute by showing kindness and supporting the individual emotionally. I am able to assist with various daily tasks and also encourage participation. 

 
What is it about PA work which appeals to you? (required): It is a very rewarding role that would give me the opportunity to make a difference in their quality of life. 

 
What are your hobbies/interests?: I enjoy watching TV and going to the cinema, playing games of all sorts whether board games or computer. I also enjoy going out for long walks with my dog and also being creative including arts and craft. 

 
Would you consider a casual position if you are unsuccessful with this job? (required): Yes 

 
Do you drive? (required): No 
Are you a vehicle owner?  (required): No 
Do you smoke? (required): No 

 
Are you able to undertake training? (required): Yes 

 
What days/nights are you able to work, or prefer to work?  (required): Any 

 
Are there any circumstances which would prevent you from providing cover or swapping a shift? (required): Yes 

 
If you would like to expand on the answers given above? Please use the box below.: I live with my parents and my dog. Very rarely my parents are unable to dogsit.  

My dog suffers with separation anxiety. 


Is there is any such information you wish to disclose, relating to any cautions or convictions which will appear on your mandatory DBS check? (required): No/ 

 
I agree that there is nothing which would prevent me from doing this job. (required): Yes 

 
I consent to the above (required): 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 

 
How many hours of work can you offer per week?: 40 

 
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/Friday PM/Saturday AM/Saturday PM/Sunday AM/Sunday PM /