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.
for more information.
Address (include zip code)
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?
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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This form was created inside of Disability Law Collective.