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Personal Assistant Application Form Submission  


Title *: Miss. 

Town *: Cardiff 

County *: Wales 


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. *: Currently a PA with another client  


What qualities do you think are important when working as a personal assistant with a disabled person? *: Reliable, friendly, hardworking. 


How do you think you can contribute towards the needs and the independence of a disabled person? *: Turning up with a positive attitude, offering friendly service. Making a difference to clients day. 


What is it about PA work which appeals to you? *: Hrs of work, helping others. 

What are your hobbies/interests?: Walking, cinema, eating out. 


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? *: Afternoons if possible  


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 currently a PA for 16 hrs .. I have spare hrs in afternoon and evenings. 

Is there is any such information you wish to disclose, relating to any cautions or convictions which will appear on your mandatory DBS check? *: Yes/ 


Please provide details if necessary: I have previous convictions from over 27 years ago. They are spent. I have a up to date DBS  


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 


How many hours of work can you offer per week?: 16 


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

Further Information: I am outgoing with a can do attitude