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Title *: Mrs. 

Address 2: St Mellons 
Town *: Cardiff 
County *: South Glamorgan 

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. *: 2015 working in social care with diverse Cymru then DewisPova Level 2. Emergency first aid. Incontinence Care. Manual handling all wales passport scheme. Autism. Level 2 food Hygiene. Diabetes awareness. all of my training is up to date. 
What qualities do you think are important when working as a personal assistant with a disabled person? *: To be patient, compassionate, caring, considerate, friendly and understanding. reliable, trust worthy, supportive and professional. 

How do you think you can contribute towards the needs and the independence of a disabled person? *: Supporting service users with various aspects of their daily life. to live as independent as possible. Maintaining dignity, choice and respect. 

What is it about PA work which appeals to you? *: The role as a PA is rewarding, helping service users. developing good working relationships whilst supporting the individual to have the quality of life they deserve. 

What are your hobbies/interests?: 

Would you consider a casual position if you are unsuccessful with this job? *: No 

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? *: Monday to Friday - 5 days a week 

Are there any circumstances which would prevent you from providing cover or swapping a shift? *: Yes 

If you would like to expand on the answers given above? Please use the box below.: If I have two PA posts. already working for a service user on that day. so I would probably be stuck to cover. 

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 have a portable DBS. My training is up to date. also experience from 2015 as a PA supporting service users. 

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?: ST Mellons. Pentwyn. Rhiwbina. Roath. Rumney. Llanishen. Lisvane. 

How many hours of work can you offer per week?: 16-20 hours per week 
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: Allergic to cats