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Personal Assistant Application Form Submission 

Title (required): Mrs. 

Address 2: Splott 
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 am an experienced accountant and come from Ukraine. The UK has helped me and my family to settle here and now I would like to help someone in my local area. For 13 years now I have brought up my lovely twin girls and back in Ukraine I also cared for my elderly father. My two cats and Lucky the dog have always been a big part of our lives. 

What qualities do you think are important when working as a personal assistant with a disabled person? (required): I have always enjoyed helping people where help is needed - I am kind, a good listener, respectful of peoples needs and love dogs! 

How do you think you can contribute towards the needs and the independence of a disabled person? (required): In my career I have needed to be organised, structured and take initiative. In my home life there has been more call for keeping a clean and loving home for our young family. I think my cooking skills would also contribute to this role. As a good listener I would try to determine the needs and together with the disabled person we could work towards more independence. 

What is it about PA work which appeals to you? (required): I would like to become more useful in my local community and help people. I would be able to give my kindness and caring as a PA to other people and a part time job as a PA would also allow me to continue looking after my twin girls at home. 

What are your hobbies/interests?: I enjoy going for walks in the countryside, looking after our dog and cats, gouache painting, listening to music and watching a good film. Shopping is always on the agenda with 13 year old twin girls! 

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): 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): Mon - Fri, 09.00 - 12.00. Saturday or Sunday 

Are there any circumstances which would prevent you from providing cover or swapping a shift? (required): No 

If you would like to expand on the answers given above? Please use the box below.: I am currently doing my ESOL Course and this means that I cannot work Mon - Fri in the afternoon. 

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?: Cardiff 

How many hours of work can you offer per week?: 18 

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