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Personal Assistant Application Form Submission 

 
Title (required): Mr. 

Address 2: Riverside 
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 worked as health care assistant with two hospitals in Nigeria (References will be provided when necessary). My duties among others include: · Assisting with daily living activities such as eating, showering and using the toilet · Utilizing equipment to move patients when necessary · Helping tidy the patients room · Taking the patients vital signs such as blood pressure and temperature · Attending meetings with other healthcare professionals · Assisting nurses and other staff when needed · Adhering to professional standards · Delivering reports to Case Managers and reviewing any important changes in the patients condition. 

 
What qualities do you think are important when working as a personal assistant with a disabled person? (required): Patience, empathy, good communication and passion for the job. 

 
How do you think you can contribute towards the needs and the independence of a disabled person? (required): I love to assist it has always been my desire to help and assist at the least opportunity. I have also been in the business of helping people professionally. 

 
What is it about PA work which appeals to you? (required): PA work helps me to contribute maximally towards making life better and more pleasant for my principal. 

 
What are your hobbies/interests?: Coding with Python, reading, cooking, cleaning, meeting people, playing chess or scrabble. 

 
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): Tuesdays, Wednesday, Friday, Saturdays and Sundays 

 
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/ 

 
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?: 20hours 

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