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Personal Assistant Application Form Submission  

 

Title *: Miss. 

Address 2: Llanishen 

Town *: 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. *: 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. *: I was completing work experience at sweet pea nursery and childcare  

 

What qualities do you think are important when working as a personal assistant with a disabled person? *: Patience, gentle, understanding, caring, trust 

 

How do you think you can contribute towards the needs and the independence of a disabled person? *: Communication with family, support, access to environments  

What is it about PA work which appeals to you? *: Helping others and giving them the best care they need 

 

What are your hobbies/interests?: Spending time with loved ones, helping my friends and family when they need me, looking after my bampy  

 

Would you consider a casual position if you are unsuccessful with this job? *: Yes 

 

Do you drive? *: No 

Are you a vehicle owner? *: No 

Do you smoke? *: No 

 

Are you able to undertake training? *: Yes 

 

What days/nights are you able to work, or prefer to work? *: I’m happy to work anytime  

 

Are there any circumstances which would prevent you from providing cover or swapping a shift? *: 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? *: No/ 

 

Please provide details if necessary:  

 
I agree that there is nothing which would prevent me from doing this job. *: Yes 

 

I consent to the above *: 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?: Llanishen, thornhill, Cyn-Coed, llanedeyrn, pentwyn  

 

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

 

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

Further Information: