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Personal Assistant Application Form Submission 

Title (required): Mrs. 

Address 1 (required): Caerau 

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): A student studying BA(Hon) Youth and community work at Cardiff metropolitan university 

What qualities do you think are important when working as a personal assistant with a disabled person? (required): Caring, respectful, flexible, communicative, friendly, reliable and empathetic 

How do you think you can contribute towards the needs and the independence of a disabled person? (required): Providing physical support which may include helping with household tasks and personal care. Providing emotional support for an individual and their families. Supporting and helping with health care needs, including routine checks or administrating medication. Encouraging and supporting the development of personal skills through hobbies and interests. Teaching life skills, such as shopping, using public transport and paying for bills. Working with other healthcare professionals to ensure that all care needs meet the highest possible standards. 

What is it about PA work which appeals to you? (required): Flexibility and opportunity to provide a wide range of support to individuals 

What are your hobbies/interests?: Cooking, singing and swimming 

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): Yes 

Are you able to undertake training? (required): Yes 

What days/nights are you able to work, or prefer to work?  (required): Monday, Wednesday, Thursday, Friday and Saturday 

Are there any circumstances which would prevent you from providing cover or swapping a shift? (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/ 

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?: Ely, canton, llandaff, grangetown gabalfa 

How many hours of work can you offer per week?: 30hrs 

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