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Personal Assistant Application Form Submission 

 
Title (required): 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): 

HSC from Bangladesh. Completed childcare taster entry 3. 

Currently doing ESOL and E1. 

Completed numeracy skills entry 3. 

 
What qualities do you think are important when working as a personal assistant with a disabled person? (required): qualities I have as a personal assistant is that I am caring, organised, efficient and punctual. I have been a mum in a joint family where I have been cooking, cleaning, and caring for three generations for a long time. I can speak in Bengali and urdu, besides English. 

How do you think you can contribute towards the needs and the independence of a disabled person? (required): I can support them and encourage them to do this work independently. I have managed my own family well for years. 

 
What is it about PA work which appeals to you? (required): a personal assistant job is flexible and short duration and will give me my independence to self develop.  

 
What are your hobbies/interests?: I like to cook and travel and help others in the community. 

 
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): 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): Weekdays during mornings, 9-12pm. 

 
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 

 
How many hours of work can you offer per week?: 6 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/