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Personal Assistant Application Form Submission 

Title (required): Miss. 

Town (required): HENGOED 

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): BA (Hons) Humanities- 2-2 I worked as a Conveyancer for many years before a change in career direction led me to become a personal assistant to an elderly gentleman with dementia in 2018 until he very recently, sadly, passed away. 

What qualities do you think are important when working as a personal assistant with a disabled person? (required): Kindness, patience, compassion, empathy and understanding. Being aware of the disability and familiar with the effects on the individual. Ensuring that the person is aware I see them as the person that they are and not a person with a disability. 

How do you think you can contribute towards the needs and the independence of a disabled person? (required): Encouraging the person to do what they can within their ability, but being an extension of the person to assist with those things that they cannot achieve. Being fully aware of their care plan and researching the disability thoroughly and continuously. 
What is it about PA work which appeals to you? (required): I thoroughly loved my last position as a PA and was sorry that I had not changed my career path sooner. I enjoyed making a difference to the individuals life on a daily basis and improving the quality of his life. 

What are your hobbies/interests?: Music, Arts, reading, visiting museums and spending time with my four young grandsons who live nearby. 

Would you consider a casual position if you are unsuccessful with this job? (required): No 

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): As required. 

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?: Ystrad Mynach, Heath, Lisvane, Merthyr Tydfil, Rhonnda Canon Taff, Caerphilly 

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

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