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Personal Assistant Application Form Submission 

Title (required): Miss. 

Address 2: 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): Health & Social Care - Level 3 I have worked in Residential care homes covering the Vale of Glamorgan for 7 years. Ive also worked as a domiciliary care worker. Providing Care and support to individuals (mostly older adults) within their own homes for 4 years. 

What qualities do you think are important when working as a personal assistant with a disabled person? (required): Reliability, honesty, kindness, patience, trustworthy, respect, dignity, the ability to listen and appreciate choices. 

How do you think you can contribute towards the needs and the independence of a disabled person? (required): I am reliable and will try my best to ensure that I am meeting all needs to the best of my ability. I feel that I am patient, I particularly enjoy working with older adults and have spent the majority of my working life, helping the elderly to live a more fulfilling life whilst keeping independence. I feel that I can keep good company and am a listening ear. 

What is it about PA work which appeals to you? (required): I have a four year old son, and I am looking for night shifts to enable me to be at home more. Ive always enjoyed working within care but am looking to replace the 12 hour day shifts with nights. 

What are your hobbies/interests?: My hobbies are going for walks, with my son and dogs. I enjoy reading, listening to music, swimming and catching up with family. 

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): Friday and Saturday 

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.: As long as a little notice was given I would be able to swap shifts. I am a driver but I dont always have access to the car as we car share. 

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: No convictions 

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, ely , caerau, Grangetown, Canton, Whitchurch. 

How many hours of work can you offer per week?: 30 

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