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Personal Assistant Application Form Submission 

 
Title (required): Miss. 

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): I have many years experience in Support work, the care industry and also with learning disabilities in a professional and a personal manor. My younger brother who is 18 has severe autism and multiple other disabilities and care needs. I also have completed multiple courses on Makaton too. 

 
What qualities do you think are important when working as a personal assistant with a disabled person? (required): A person centred approach is paramount when caring for a disabled person. Also, everybody is different so treating each person as an individual is incredibly important. 

 
How do you think you can contribute towards the needs and the independence of a disabled person? (required): I am a very experienced, kind, caring and considerate girl who loves to care for people. 

 
What is it about PA work which appeals to you? (required): I love to be able to support people in their everyday lives. 

 
What are your hobbies/interests?: I love going for walks, spending time with friends and family and going shopping. 

 
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): Fully flexible 

 
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?: Cardiff (fully flexible as I drive) 

 
How many hours of work can you offer per week?: 40 

 
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/Wednesday AM/Wednesday PM/Wednesday Overnight/Thursday AM/Thursday PM/Thursday Overnight/Friday AM/Friday PM/Saturday AM/Saturday PM/Sunday AM/Sunday PM / 
Further Information: