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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): Acumen Care Services- Support worker Nov 2021- Dec 2022 

What qualities do you think are important when working as a personal assistant with a disabled person? (required): Flexibility Good communication skills Patience Respect Ability to multitask Attention to detail 

How do you think you can contribute towards the needs and the independence of a disabled person? (required): See the person and not the disability, by encouraging them, asking questions, listening to them, actively interacting with them in decision making. 

What is it about PA work which appeals to you? (required): Ive always been interested in work that involves helping others and making a positive impact. I enjoy being an active member of my community and helping people. Helping them retain as much independence as possible with as much dignity as possible is always my primary goal. 

What are your hobbies/interests?:Reading books Taking walks Listening to music Meeting new people 

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): 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): Wednesday, Friday and Sunday 

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.:Uni classes  

Do you have portable DBS (which has been paid for and renewed for the current year)? (required): Yes/ 

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/ 

Please provide details if necessary: 

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): 20 

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