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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): I have completed a course in Adult Social Care and i have also been a teaching assistant. I am familiar with vulnerable customers. Furthermore, i have been a nanny for 3 years. 

What qualities do you think are important when working as a personal assistant with a disabled person? (required): Empathy, patience, having a calm presence is essential to put individual at ease. 

How do you think you can contribute towards the needs and the independence of a disabled person? (required): I believe i have the necessary skills to support a disabled person with independence by providing them with an environment working at a pace which helps them. I am flexble in my approach to help the customer maintain a good quality of life. 

What is it about PA work which appeals to you? (required): I have extensive experience working with vulnerable people. I appreciate supporting someone in having the best quality of life in their life to make a real difference in their life. 

What are your hobbies/interests?:i enjoy drawing and listening to music. I enjoy cooking and sowing as well. 

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

Do you speak any other languages? (required): Arabic 

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): fully flexible. 

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

If you would like to expand on the answers given above? Please use the box below.:n/a 

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

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: n/a 

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?:Cyncoed, Penylan, Heath, City Centre, Llanedeyrn, City/Albany Road. Newport Road, Cardiff area which are accessible through public transport 

How many hours of work can you offer per week? (required): 20-25 hours 

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