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Personal Assistant Application Form Submission 

 

Title *: Miss. 

Address 2: Gabalfa 

Town *: 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. *: 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. *: I am working with an agency presently I have been involved with Dewis as long ago as when it was called the Coalition of disabled people and I was interviewed by wonderful lady by the name of Kay Jenkins I have experience over many years but I believe more importantly I still have a passion to remain in this role 

 

What qualities do you think are important when working as a personal assistant with a disabled person? *: To be supportive and attentive To care To be practical and thoughtful To be honest To keep confidentiality 

 

How do you think you can contribute towards the needs and the independence of a disabled person? *: I can support the needs of a disabled person In the way they would like to be supported Good communication and understanding will help to be a good team together 

 

What is it about PA work which appeals to you? *: Knowing that I am of assistance and making a difference to someones life In a positive role To help someone live Their best life 

 

What are your hobbies/interests?: I like to go fishing 

 

Would you consider a casual position if you are unsuccessful with this job? *: Yes 

 

Do you drive? *: Yes 

 

Are you a vehicle owner? *: Yes 

 

Do you smoke? *: No 

 

Are you able to undertake training? *: Yes 

 

What days/nights are you able to work, or prefer to work? *: All 

 

Are there any circumstances which would prevent you from providing cover or swapping a shift? *: No 

 

If you would like to expand on the answers given above? Please use the box below.: I am keen to secure some support role with someone who is in need of support  

 

Is there is any such information you wish to disclose, relating to any cautions or convictions which will appear on your mandatory DBS check? *: No/ 

 

Please provide details if necessary: None 

 

I agree that there is nothing which would prevent me from doing this job. *: Yes 

 

I consent to the above *: 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?: Cardiff in the main  

 

How many hours of work can you offer per week?: 40  

 

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: Thank you