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Personal Assistant Application Form Submission 

 
Title (required): Mrs. 

Address 1 (required): Cyncoed 
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): Hello I have worked 121 with children with autism in a local primary school was a rewarding job thoroughly enjoyed it 

 
What qualities do you think are important when working as a personal assistant with a disabled person? (required): I have a calm nature very patient and caring have 3 grown children of my own so have a motherly nature 

 
How do you think you can contribute towards the needs and the independence of a disabled person? (required): Helping them achieve there daily tasks and enjoying time spent with them 

 
What is it about PA work which appeals to you? (required): Rewarding and I have a good way with children it’s something I would Be interested in very much 

 
What are your hobbies/interests?: Walking anything fun have 2 dogs which I adore love being out and about 

 
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): Any day as long but unfortunately no night work 

 
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/ 
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?: Roath Heath llanishen 

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

 
Please indicate the approximate times that you are available for work throughout the week.: Tuesday AM/Tuesday PM/Wednesday AM/Thursday AM/ 
Further Information: I am flexible with hours but wouldn’t be able to do overnight stays