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* 1. Full Name

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* 2. Full Address

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* 3. Email Address

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* 4. Phone Number

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* 5. Emergency Contact (name, contact, relationship)

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* 6. Country of Origin

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* 7. Gender

 
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* 8. Year of Birth

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* 9. Do you have a business idea at the moment?

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* 10. Do you consider running your own business as a career option?

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* 11. Have you taken any entrepreneurship training before?

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* 12. Have you ever attempted to start your own business or assisted someone else in an entrepreneurial pursuit?

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* 13. Are you presently working?

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* 14. How do you think you will benefit from this program?

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* 15. Are you available to start the program on Wednesday April 15, 2015 and commit to 12 consecutive weeks of training (Wednesdays, 5:30-7:30 p.m.) at 791 St. Clair Avenue West Toronto?

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THANK YOU FOR YOUR TIME, WE WILL BE IN TOUCH SHORTLY WITH NEXT STEPS.

If you have any questions in the meanwhile please don`t hesitate to get in touch with our Intake&Assessment Counsellor, Trudi at tkilpatrick@skillsforchange.org or 416-658-3101 ext. 221.

THANK YOU FOR YOUR TIME, WE WILL BE IN TOUCH SHORTLY WITH NEXT STEPS.<br><br>If you have any questions in the meanwhile please don`t hesitate to get in touch with our Intake&amp;Assessment Counsellor, Trudi at tkilpatrick@skillsforchange.org or 416-658-3101 ext. 221.

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