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Personal Assistant Application Form Submission 

Title (required): Miss. 

Address 2: Caerau 
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 have looked after a member of family who had a stroke 8 years ago . I provide all aspects of care along side his care team . I’m no longer working hands on as he has a full double handed care plan . I have many years experience. 

What qualities do you think are important when working as a personal assistant with a disabled person? (required): I’m a very caring person who understands totally about this roll working along side a family member and in the community. I love the whole job role as I’m very sociable with a happy nature. 

How do you think you can contribute towards the needs and the independence of a disabled person? (required): I’m very experienced so I could walk straight into this roll with full understanding of what the person needs . 

What is it about PA work which appeals to you? (required): I love the one to one working, creating that bond with the client on a one to one basis . I have worked in the community and found it a cold place to work with not much time in each job to interact with the clients . This role suits me most . 

What are your hobbies/interests?: I love walking I’m very active I normally walk 5 miles a day when I have time . I like to eat out when I can and also like swimming. 

Would you consider a casual position if you are unsuccessful with this job? (required): No 

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): Days 

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, Barry , Penarth 

How many hours of work can you offer per week?: 18-19 

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/ 

Further Information: I would rather work days Monday - Friday but could help on the weekend if required to .