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Personal Assistant Application Form Submission 

 
Title (required): Mr. 

Address 2: Cathays 

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 previously worked as health and social care worker in Norwich or six months. In this I visited service users in their homes and help them with tasks they struggle with, such as cooking, washing, and getting out of bed. 

 
What qualities do you think are important when working as a personal assistant with a disabled person? (required): Being empathetic/understanding of how a condition will effect someones life and their feelings. Problem solving to find potential ways around limitations. Being trustworthy and loyal. Being friendly. 

 
How do you think you can contribute towards the needs and the independence of a disabled person? (required): I will support and encourage in doing what they want. I am organised and can stay calm in stressful situations. I good at intuiting what may be needed in different situations and good at thinking of solutions to problems. 

 
What is it about PA work which appeals to you? (required): Being a PA will allow me to help people. It will also help me develope better communication skills for the future. 

 
What are your hobbies/interests?: I enjoy reading, gaming, and kayaking. I am also interested in other activates like swimming, gym, or cycling. I love animals especially cats. 

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

 
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): I am able to work in the evenings of week days. I would prefer to work on weekends at any time. 

 
Are there any circumstances which would prevent you from providing cover or swapping a shift? (required): Yes 

 
If you would like to expand on the answers given above? Please use the box below.: I am currently studying full time at university so I need the weekday for uni. I will also not be working at all the available times so I have time to study for university. The times I work will be determined by any job that I get. 

 
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: 

 
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?: Cardiff 

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

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

 
Further Information: I am available on week day past 5pm. I am available on weekends at any time. This is because I am currently studying at university full time.