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Personal Assistant Application Form Submission 

 
Title (required): Mrs. 

Address 2: Tremorfa 
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): I have taken quite early retirement from the NHS where I worked in the community as a Nursery Nurse. This was to help take care of my Granddaughter who is now 3 years old. Since 16 years old I have worked in nursing homes, hospitals and in the community. I have 2 Dewis clients one of which I have been with for approximately 18 years, both clients are in wheel chairs and one uses a hoist. 

 
What qualities do you think are important when working as a personal assistant with a disabled person? (required): When working with a disabled person you need patience, empathy, friendliness, care, honesty, and a good sense of humour is essential. 

 
How do you think you can contribute towards the needs and the independence of a disabled person? (required): I am always reliable, have good time keeping, a very good sense of humour and a bubbly personality. With years of caring in various jobs I can remain calm under pressure and always respect the wishes of my client and their family. 

 
What is it about PA work which appeals to you? (required): Having a wonderful relationship with my clients and making there lives enjoyable, whilst enabling them to be happy in there own homes and environment. 

 
What are your hobbies/interests?: I craft a lot, I have a she shed where I make personalised gifts, t shirts and cards. We have a Motorhome which we love and try and get away for weekends either by the sea or in the country for long walks and chilling. I also like to cook foods from around the world, wish I ate more fish though. 

 
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): Monday night, Tuesday night, Wednesday night and Thursday night. Start and finish times pending may be available for more. 

 
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.: Already cover a Sunday night at my Dewis clients, the other night I cover is every other Monday which I would drop for another permanent night a week. Maybe if Granddaughter takes ill, but fortunately she’s suffered very little so far, with just a common cold. 

 
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?: I drive, have my own car so anything around Splott, Llanedeyrn, Pentwyn, Rumney, Heath areas are fine. 

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

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