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    Registration Form: Pathways To Employment Mining Training Program

    Uploaded by

    Luz Fowler
    This document is a registration form for the Pathways to Employment Mining Training Program. It collects personal information such as name, address, phone number, education history, emergency contacts, and consent for the disclosure of academic records. Applicants are also asked to rate their math and literacy skills and whether they are willing to upgrade skills as part of the training. The form is to be returned to Jocelyn Bebamikawe at the Wikwemikong WDC by fax or email.

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    Registration Form: Pathways To Employment Mining Training Program

    Uploaded by

    Luz Fowler
    36 views2 pages
    This document is a registration form for the Pathways to Employment Mining Training Program. It collects personal information such as name, address, phone number, education history, emergency contacts, and consent for the disclosure of academic records. Applicants are also asked to rate their math and literacy skills and whether they are willing to upgrade skills as part of the training. The form is to be returned to Jocelyn Bebamikawe at the Wikwemikong WDC by fax or email.

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    Mining Program Registration Wikwemikong, Ontario

    Original Title

    Registration Form

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    This document is a registration form for the Pathways to Employment Mining Training Program. It collects personal information such as name, address, phone number, education history, emergency contacts, and consent for the disclosure of academic records. Applicants are also asked to rate their math and literacy skills and whether they are willing to upgrade skills as part of the training. The form is to be returned to Jocelyn Bebamikawe at the Wikwemikong WDC by fax or email.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    36 views2 pages

    Registration Form: Pathways To Employment Mining Training Program

    Uploaded by

    Luz Fowler
    This document is a registration form for the Pathways to Employment Mining Training Program. It collects personal information such as name, address, phone number, education history, emergency contacts, and consent for the disclosure of academic records. Applicants are also asked to rate their math and literacy skills and whether they are willing to upgrade skills as part of the training. The form is to be returned to Jocelyn Bebamikawe at the Wikwemikong WDC by fax or email.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Pathways to Employment Mining Training Program

    Return this form to: Jocelyn Bebamikawe, Wikwemikong WDC [email protected] or fax 705-859-2000

    Registration Form
    Last Name: First Name: Previous Last Name (if applicable): Address: City: Phone (home): Email: Date of Birth (YY/MM/DD): Please check: How did you hear about the program: Newspaper ___ Friend____ Parent____ Flyer____ Information Session ____ Facebook___ Email ____ Employment Officer ____ OW Worker ___ Other: ______________________________ Aboriginal Descent First Nation (please specify) _______________________________ Metis Have you ever been on E.I.? Yes Inuit No (If yes, when? ______________) No Gender: Male Female Province: Cell Phone: Postal Code: Second Name:

    Do you have a valid drivers license? Yes

    Do you have a secondary school diploma? Yes No If no, what was the highest grade you completed? _____________ Have you attended any post-secondary institution? Yes No / If yes, College University What program(s) did you take? ____________________________________ Please rate your strengths on a scale of --- 1(lowest) 2, 3, 4, or 5 (highest) Adding ____ Subtracting ___ Dividing ___ Multiplying ____ Measurements _____ Fractions ____ Writing _____ Reading ____ Are you willing to upgrade your literacy and numeracy skills as part of this training? Yes Turn page over 1 No

    Pathways to Employment Mining Training Program


    Return this form to: Jocelyn Bebamikawe, Wikwemikong WDC [email protected] or fax 705-859-2000

    In case of an emergency whom can we contact? Name: Relationship to you: Phone:

    Consent to Disclosure
    I certify that the above information is true and complete. I understand that any false or incomplete information may invalidate my application. I have read the Freedom of Information and Privacy Protection statement below. I authorize my previous educational institutions and/or the Ministry of Education to release my academic information and school record to the above mentioned college. I also authorize the release of this information to the Ministry of Training, Colleges and Universities. I authorize Canadore College to disclose academic information as required to sponsoring agencies or other adult education providers.

    Applicants Name (please print) _________________________________________________________ Applicants Signature _________________________________ Date __________________

    Freedom of Information and Protection of Individual Privacy


    The personal information on this application is collected under the legal authority of the Ministry of Colleges and Universities Act, R.S.O. 1990,c.M.19,s.5 and Regulation 770, R.R.O.1990,s.8. The information is used for the administration and statistical purposes of the College and/or the Ministries and Agencies of the Government of Ontario and the Government of Canada. If you have any questions regarding the collection and use of this personal information, please contact the Registrar of the College.

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