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Personal Assistant Application Form Submission 

Title (required): Mrs.

Town (required): Splott
County (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): General housekeeping, I follow the client to the hospital and social function, I know when people are not happy and try to make my shift as interesting as I can ,I enjoy companionship with adult, my grandmother has earing disability and she enjoys my company 

What qualities do you think are important when working as a personal assistant with a disabled person? (required): Patience, kindness, empathy, good listener and observer. 

How do you think you can contribute towards the needs and the independence of a disabled person? (required): Understanding the use of their aid equipment that can help them more Making them understand that disability is no limitations to achievements 

What is it about PA work which appeals to you? (required): The joy of satisfaction and improvement of my client 

What are your hobbies/interests?:Reading, travelling, listening to music 

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

Do you speak any other languages? (required): No 

Do you drive? (required): Yes 
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): Days/night 

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

Do you have portable DBS (which has been paid for and renewed for the current year)? (required): No/ 

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? (required): 48 hours plus 

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