First Name:

Last Name:

4-Digit Pin:

**Note
Your 4-digit pin can be found on the back of your AIM Hotline Card. You will need to have your pin in order to access the list of Personal Assistants.  If you have lost or forgotten your pin, or do not have one, please contact AIM at 607-962-8225.

Select county where you'd like to recieve services:
Allegany
Chemung
Schulyer
Steuben

Select type of assistant you are seeking:
Continual Employment
Sick and Vacation Time

Please select shift:
Morning (6am - 12pm)
Afternoon (12pm - 6pm)
Evening (6pm - 12am)
Overnight (12am - 6am)

Number of hours per week:
1-10 hours
10-20 hours
20-30 hours
30-40 hours

Gender preference:
Female
Male
No preference