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Personal Assistant Application Form Submission  

 
Title *: Miss. 

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. *: When I lived in South Africa I was a care worker in the same capacity as this job description. I would work with the service user in their home, taking care of their personal needs, shopping and cooking and taking then out and about although at the moment that might be easier said than done. 

 
What qualities do you think are important when working as a personal assistant with a disabled person? *: I consider myself to be a kind and conscientious person and feel I can contribute towards improving someone else quality of life and be good company for them. With everything that is going on at the moment I believe it is more important than ever to help people that are feeling socially isolated and where possible enable them to lead a more fulfilling life.  

 
How do you think you can contribute towards the needs and the independence of a disabled person? *: I am a good cook and can make interesting meals for people. I know how difficult it is for people with disabilities to be active members of society so I would see my role as getting them out and about and involved in their community. 

 
What is it about PA work which appeals to you? *: I enjoyed the work when I did it in the past and feel I have a natural aptitude for this type of work. 

 
What are your hobbies/interests?: I am an active member of my church and enjoy spending time with the rest of the congregation. 

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

 
Do you drive? *: No 
Are you a vehicle owner? *: No 
Do you smoke? *: No 

 
Are you able to undertake training? *: Yes 

 
What days/nights are you able to work, or prefer to work? *: I am flexible about when and where I can work. 

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

 
Please provide details if necessary:  

 
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?:  

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

 
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: