Application Form for all 2018-2019 Programs

Personal Information

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* 1. Personal Information

What is your date of birth?

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* 2. What is your date of birth?

Date / Time
What is your residency?

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* 3. What is your residency?

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

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

Financial Information - Please select all that apply to you

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

Education- Please select all that apply

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* 6. Education- Please select all that apply

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

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

Do you have any volunteer experience?

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* 8. Do you have any volunteer experience?

How do you spend your spare time?

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* 9. How do you spend your spare time?

What's important to you?

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* 10. What's important to you?

What do you want us to know about you?

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

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

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

Please tell us one long term and one short term goal you have

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

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

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

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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* 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.

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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* 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)

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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* 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.

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

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

Which program are you applying for?

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* 19. Which program are you applying for?

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

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

How did you learn about the program?

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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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