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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): 

3 months work experience, as a volunteer in British heart foundation. 

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

I have previously cared for my mother with health conditions, post stroke. I cared for her personal care and domestic support. 

How do you think you can contribute towards the needs and the independence of a disabled person? (required): i can support the person to cater for their needs and also be helpful, by having knowledge of Bengali language skills to communicate. 

What is it about PA work which appeals to you? (required):  its flexible and gives a community spirit. I can help others in need.  

What are your hobbies/interests?: I like watching tv, cooking, cleaning, gardening and stitching and sewing. 

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): during the day between 10-2pm. Monday- Thursday. 

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, Penylan.  

How many hours of work can you offer per week?: 8-10 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/