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Personal Assistant Application Form Submission 

 
Title (required): Mrs. 

Town (required): Cardiff 
County (required): 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. (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): 

HSC Bangladesh. ESOL entry 3. 

Child care tester entry 3, digital. 

 
What qualities do you think are important when working as a personal assistant with a disabled person? (required):  

I have been a mum for many years, so I have been caring for them. I have worked as a babysitter too, for a family recently. I have worked with an autistic child to support him at home to engage with activities. I have been a volunteer in a secondary school to support children in clubs. 

 

How do you think you can contribute towards the needs and the independence of a disabled person? (required): I have done some courses which has given me skills to support children with their individual needs. I am a confident and fun loving person, who lives to work with children. 

 
What is it about PA work which appeals to you? (required):  the work is flexible and abatable, and suits me as it gives me a work and family balance. 

 
What are your hobbies/interests?: I like cooking, travelling, cleaning and reading. 

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

 
Do you drive? (required): Yes 
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): Weekdays, Monday- Friday 10-2pm. 

 
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?: Roath and Cathays, Gabalfa 

 
How many hours of work can you offer per week?: 6-8 hrs 

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