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Personal Assistant Application Form Submission 

Title: Mrs 
Town (required): 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. (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): English Language O’level English Literature O’level Mathematics GCSE Accounts A’level AAT (Assiciation of Accounting Technicians) 

What qualities do you think are important when working as a personal assistant with a disabled person? (required): Patience, kindness and understanding. 

How do you think you can contribute towards the needs and the independence of a disabled person? (required): I am a very caring and kind person and am not afraid of hard work. I have lots of friends and get on well with others. I have a good sence of humour and feel I am good company. I am educated to a high standard and admin will be no problem for me. I love animals. 

What is it about PA work which appeals to you? (required): I have worked in an office for many years but have always wished I was working helping others. Now that I have retired I am able to follow my ambitions. 

What are your hobbies/interests?:I love reading, watching dramas, walking my dog and socialising. 

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

Do you speak any other languages? (required): No 

Do you drive? (required): No 
Are you a vehicle owner?  (required): Yes 
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): Any days, not nights. 

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

If you would like to expand on the answers given above? Please use the box below.:I am partially sighted but this has never stopped me from doing anything. I have always been independent and there is nothing I can’t do. 

Do you have portable DBS (which has been paid for and renewed for the current year)? (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/ 

Please provide details if necessary: 

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?:Llanedeyrn, Pentwyn, Pontprennau, Penylan 

How many hours of work can you offer per week? (required): Up to 12 

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/Saturday AM/Sunday AM/