Personal Assistant Survey
Personal care assistants needed for young professionals with physical disabilities in downtown Arlington Heights, IL.
Duties include: bathing, feeding, toileting, dressing, cooking, and household chores. No previous experience required.

Contact for more information.
Name *
Email address *
Address (include zip code) *
Phone *
What 3 words best describe you as a person? (Please only choose the top three) *
Describe yourself and your personality? *
What experiences do you have with people with disabilities? *
Do you own a car with insurance? *
Are you willing to use your car for work purposes? *
You might be asked to work Weekday Mornings from 8 to 10 AM and/or Certain Weekend Mornings: 9 to 11 AM. When would you be available? *
You might be asked to work Weekday and/or Weekend dinner shifts: 5 to 7 PM. When would you be available? *
From the above shifts, do you have the flexibility to start or end earlier or later? *
If necessary, would you be able to change the days that you work if given notice a few days before?
Clear selection
Would you be willing to be on call/sub if another assistant can't make her shift? *
Interest in the position: *
Very high: I want only this job
Very low: I am exploring my options
Optional: Paste your resume or any information that make you shine from the other applicants.
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