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  • Personal Data Form - Ivcil.com

Get Personal Data Form - Ivcil.com

Illinois Valley Center for Independent Living 18 Gunia Drive LaSalle, IL 61301 (815) 224-3126, Ext. 13 Fax: (815) 224-3756 Email: pac ivcil.com Please read this information before completing your.

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How to fill out the Personal Data Form - IVCIL.com online

Filling out the Personal Data Form for IVCIL's Personal Assistant Referral Registry is an essential step for individuals interested in being considered for this program. This guide provides clear and supportive instructions to ensure that you understand each section of the form and can complete it accurately and thoroughly.

Follow the steps to successfully complete your Personal Data Form online.

  1. Press the ‘Get Form’ button to access the Personal Data Form. This action will open the form in your preferred editor for completion.
  2. Begin by entering your personal information. Fill in your last name, first name, middle name, any maiden name, other names used, and current address including city, state, and zip code.
  3. Provide your social security number and date of birth. Include a contact number for home, work, and message/cell if applicable.
  4. If you have a driver's license, enter the license number and expiration date. Specify if you have auto insurance and dependable transportation.
  5. Indicate whether you have ever been convicted of a crime, including a detailed explanation if applicable. Similarly, note if you have received any traffic tickets.
  6. Answer questions about your experience working with people with disabilities and your willingness to assist as an emergency personal assistant.
  7. Mark your availability for each day of the week and bring attention to the geographic areas you wish to be employed in.
  8. Complete the skills section by marking your training status in various areas of personal assistant services, both skills you are trained in and those you are willing to be trained in.
  9. Submit your employment history, ensuring that all information is complete and follows the required format. It is important to be honest and thorough.
  10. List professional references, ensuring these are not relatives or friends, and provide complete contact information for each reference.
  11. Read and sign the acknowledgment and authorization section, confirming that you understand and agree to the terms regarding your application.
  12. After completing the form, make sure to check for any missing or illegible information. Once completed, save the document and share, print, or download it as needed.

Complete your Personal Data Form online today to take the first step towards becoming a personal assistant!

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