Independent Living Advocacy
promoting the empowerment of disabled people

Independent Living Advocacy Independent Living Advocacy Independent Living Advocacy Independent Living Advocacy

As from 21 June 2017 ILA will not be accepting new Application Forms for positions we are advertising for our clients and your details will be deleted from the Personal Assistant Register as the organisation will be closing.

Please contact 'We Are Purple' on 01245 392300 / www.wearepurple.org.uk as they have been awarded the new contract with Essex County Council as from 1 July 2017.

 

 
 
 
 
 
 

About You

Name Title*
First Name*
Last Name*
Address*
Town*
County*
Postcode*
Telephone*
Email Address*
National Insurance No*
Nationality*
   
Do you smoke?*
Gender*
   
Are you willing to do 24-hour live-in care when required?*
Are you willing to 'sleep-over' occassionally?*
Would you help us with emergency cover/on call?*
Would you like to join our PA Register?*
Do you hold a current Criminal Record Bureau (CRB) Check?*
CRB Check Date
CRB Form Reference

* indicates a required field, if you cannot answer a please type 'not applicable' or 'n/a'

Having problems completing the form? Call us today on the number listed below.