Read Address guidance, section 1. Postcode These are the Phone details of the person who Email needs care and support Age of I am 18 years or older employer This application is for someone under 18 and pays people to be Personal budget from social care How do you their PA. fund your Personal health budget PAs? Self-funded This section Organisation must be that you completed in your full. personal budget If the person No of PAs No of PAs who needs employed training care and support is under the age of 18, then Who is the these should Employer PA Both training for? be the details of the adult acting on their behalf. Section 2 Bank details (this section must be completed in full) GET IT RIGHT Sort code
Read guidance, section 1. These are the details of the person who needs care and support and pays people to be their PA. This section must be completed in full. If the person who needs care and support is under the age of 18, then these should be the details of the adult acting on their behalf. Address Postcode Phone Email Age of employer I am 18 years or older This application is for someone under 18 How do you fund your PAs? Personal budget from social care Personal health budget Self-funded Organisation that you your personal budget No of PAs employed No of PAs training Who is the training for? Employer PA Both Section 2 Bank details (this section must be completed in full) GET IT RIGHT Sort code
Individual-employer-funding-application-form-word-version.docx