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Personal Assistant Application Form Submission 

 
Title (required): Miss. 

Address 2: Pentrebane 
Town (required): Cardiff 
County (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): Health and social care nvq level 2 

 
What qualities do you think are important when working as a personal assistant with a disabled person? (required): To offer support, be a friendly face, have a good sense of humour, reliable and time conciencious. Be a good listener and sympathetic, be a friend. 

 
How do you think you can contribute towards the needs and the independence of a disabled person? (required): I am friendly and optimistic, have worked for many years with children and adults with additional learning and physical needs. Have a lot of experience and enjoy helping people. 

 
What is it about PA work which appeals to you? (required): Getting to know people, offering help and support, learning what makes someone happy and helping them access the things they enjoy. 

 
What are your hobbies/interests?: Keeping fit, taking the dog for a walk. Eating out, socialising with friends. 

 
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 to friday evening and Saturday and Sunday morning 

 
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?: Most of Cardiff 

 
How many hours of work can you offer per week?: 10 

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

 
Further Information: I am a Physiotherapy Assistant and have worked 20 years plus in health and social care