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Personal Assistant Application Form Submission


Title (required): Mrs.

Address 2: Ely
Town (required): Cardiff
County (required): Wales


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 worked as a carer for last five years for an agency so therefore I’m fit for this job


What qualities do you think are important when working as a personal assistant with a disabled person? (required): Patient Empathy Respect Positivity Preparation Detail oriented


How do you think you can contribute towards the needs and the independence of a disabled person? (required): Support Build confidence Provide useful information


What is it about PA work which appeals to you? (required): Having had some experience of caring elderly people, I enjoyed the challenge that the role presented, and I also very much enjoyed the responsibility of providing the right level of care to the person I am looking after


What are your hobbies/interests?: My hobbies are gardening, cooking, shopping, watching tv, going out with family


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): Sunday and Monday (any other days could discuss in the interview)


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’m a mother of three so I have to balance my work life but could discuss earlier about swapping shifts and for cover. I will do my level best with my ability.


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?: Llandaff, Ely, Fairwater


How many hours of work can you offer per week?: 20-30 Hours per week


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