Application Form for all 2018-2019 Programs

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* 1. Personal Information

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* 2. What is your date of birth?

Date / Time

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* 3. What is your residency?

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* 4. Do you currently have an Employment Assistance Services worker? (i.e CDS, CMHA, PEI CoD, PEI ANC, MCPEI, etc)

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* 5. Financial Information - Please select all that apply to you

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* 6. Education- Please select all that apply

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* 7. What kind of paid work have you done in the past 5 years?

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* 8. Do you have any volunteer experience?

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* 9. How do you spend your spare time?

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* 10. What's important to you?

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* 11. What do you want us to know about you?

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* 12. Why are you applying for programming at this time in your life?

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* 13. Please tell us one long term and one short term goal you have

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* 14. What motivates you (to make change in your life)?

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* 15. Is there a job or area of work that you are interested in exploring? If yes, please tell us why it appeals to you.

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* 16. If needed, are you willing to upgrade your education to achieve your career goals? (eg. GED, Adult Education courses such as English, Math, Sciences etc)

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* 17. Are you able to commit full-time to (Monday-Friday) to programming? 
 
The attendance expectation for our program is that participants commit to a 8:30am-4:30pm schedule from Monday-Friday for 12 weeks. A minimum attendance rate of 85% is needed to complete the program.

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* 18. What things may prevent you from fully participating in all program days & activities?

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* 19. Which program are you applying for?

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* 20. What is the best way to reach you? (please select all that apply)

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* 21. How did you learn about the program?

Thank you for your application. We will be in touch with you shortly

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