First Name
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Last Name
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Email
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Phone
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Where do you live (city and province)?
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Your Residency Status in Canada
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Canadian Citizen
Permanent Citizen
Protected Person- Legally Approved
Employment Insurance
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Currently on EI
CERB
Canada Recovery Benefit
None of the above/ Not Sure
Income Assistance
Others
Are you prepared to study full-time classes? [20 hours/week]
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Yes
No
Other :
Are you currently unemployed?
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Yes
No, work less than 30 hours
No, work more than 30 hours
I confirm that the information given in this form is true, complete and accurate. The information disclosed/exchanged will be treated as confidential and will be used only by the agencies listed above in conjunction with your application for service.
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Yes, I agree
Submit