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Personal Assistant Application Form Submission 

 
Title (required): Mrs. 

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 did some LSA work as a supply from teaching personal. 

 
What qualities do you think are important when working as a personal assistant with a disabled person? (required): Iam very caring passionate about children l really love children. 

 
How do you think you can contribute towards the needs and the independence of a disabled person? (required): To support them in any way make them feel comfortable. 

 
What is it about PA work which appeals to you? (required): To help children feel safe and secure. 

 
What are your hobbies/interests?: Cooking 

 
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): No 

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

 
What days/nights are you able to work, or prefer to work?  (required): Any 

 
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/ 

 
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?: 20 

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