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Title (required): Miss. 

Town (required): Cardiff, 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. (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): 7th January 2021 — 8th January 2023 Health Care Assistant • Graceline Specialist and Clinical Services • Ota, Ogun State, Nigeria • Assist to clean the client ward. • Filling the client observation book. • Assist client on outdoor exercise and work. • Assist with personal care including bathing and showering. • Assist client with food preparation and maintaining a healthy diet. • Providing essential emotional support, comfort and companionship. • Following safe lifting techniques and individual client listing instructions 

What qualities do you think are important when working as a personal assistant with a disabled person? (required): Communication, ability to listen, interpersonal skills, advocacy skills, flexibility, ability to treat people with dignity, punctuality, dedication and commitment. 

How do you think you can contribute towards the needs and the independence of a disabled person? (required): I can be supportive, not controlling, helping them to make decisions by introducing choices every day, being patient and positive at all times, celebrate little victories and encourage interaction with other people. 

What is it about PA work which appeals to you? (required): The flexibility, rewards, opportunity to meet different people 

What are your hobbies/interests?: Reading, cooking 

Would you consider a casual position if you are unsuccessful with this job? (required): Yes 

Do you drive? (required): No 
Are you a vehicle owner?  (required): No 
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): ALL 

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

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?: Cardiff 

How many hours of work can you offer per week?: 20 

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