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Personal Assistant Application Form Submission 

Title (required): Mr. 

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): Bsc in Chemistry Mendel care home Nigeria EXPERIENCE Support people with social and physical activities Check they are taking their prescribed medications Give emotional and practical support 

What qualities do you think are important when working as a personal assistant with a disabled person? (required): Good listening and communication skills Good interpersonal skills to work with someone on a one and one basis The ability to work on your own initiative 

How do you think you can contribute towards the needs and the independence of a disabled person? (required): Treat everyone as you would like to be treated Avoid showing pity Be supportive Always ask before giving assistant 

What is it about PA work which appeals to you? (required): Run errands as requested Plan travel Help with daily time management 

What are your hobbies/interests?: sports Listening to music Travelling Learning new things Reading news 

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): Both, but night will be okay 

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?: CF24 4BZ 

How many hours of work can you offer per week?: 20 

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/Friday Overnight/Saturday AM/Saturday PM/Saturday Overnight/Sunday AM/Sunday PM /Sunday Overnight/