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Title (required): Miss. 

Town (required): Newport 

 
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): BSC HUMAN RESOURCE Management 

 
What qualities do you think are important when working as a personal assistant with a disabled person? (required): Treat everyone as you would treat yourself Always ask before giving assistance Think before you speak Avoid showing pitty 

 
How do you think you can contribute towards the needs and the independence of a disabled person? (required): Treat them as I would treat myself 

 
What is it about PA work which appeals to you? (required): Being able to reach out to someone 

 
What are your hobbies/interests?: Cooking meeting new people reading swimming 

 
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): Thursday to Sunday 

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

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

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