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Personal Assistant Application Form Submission 

 
Title (required): Miss. 

Address 2: Grangetown 
Town (required): Cardiff 
County (required): South Glamorgan 

 
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 cared for my elderly grandmother and my disabled father (who had suffered two strokes) from 1986 to 2009. I worked briefly for the Sisters of Nazerth, following my fathers death. I always felt energized when toileting, providing personal care and taking care of all the other needs of those I cared for - including my friend, who suffered from vascular dementia (from 2016-2017). 

 
What qualities do you think are important when working as a personal assistant with a disabled person? (required): Empathy, Reliability, Punctuality, being observant and attentive to their needs. 

 
How do you think you can contribute towards the needs and the independence of a disabled person? (required): By giving the disabled person informed choice. 

 
What is it about PA work which appeals to you? (required): I toileted my mother when I seven - just as other people embark on various other skills and talents. Caring is in my bones. 

 
What are your hobbies/interests?: Praying, reading, watching wildlife programmes on TV, tracking down friends and acquaintances, to make sure that the are OK. 

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

 
Do you drive? (required): Yes 
Are you a vehicle owner?  (required): Yes 
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): Monday, Tuesday, Thursday, Saturday, 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.: Only if I have a prebooked appointment that I am unable to change. 

 
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?: Grangetown, Riverside, Canton, Fairwater, Llandaff, Whitchurch, Butetown. 

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

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