Atlantic Immigration Program

Employer Designation Application Form

Government of Newfoundland and Labrador
The Atlantic Immigration Program is an employer driven immigration
program aimed at addressing labour market needs in the four Atlantic
Acronym Glossary:
Provinces. AIP – Atlantic Immigration Program
Designation is the first step for an employer interested in participating
ECA – Educational Criteria Assessment
in the program. The designation process is designed to confirm that:
IRCC – Immigration, Refugees and
• The Atlantic Immigration Program is the immigration program Citizenship Canada
best suited to address the employer’s needs;
• The employer wants to hire full-time, non-seasonal international IRPA – Immigration and Refugee
candidates, at a minimum of 30 hours/week; Protection Act
• The employer and their business has been in continuous, active
IRPR – Immigration and Refugee
operation under the same management for at least two years
in the Atlantic Region and in good standing as per the Protection Regulations
program guidelines; LMIA – Labour Market Impact
• The employer has agreed to and demonstrated their Assessment
commitment to maintain a welcoming workplace;
• The employer has committed to supporting the candidate and MOU – Memorandum of Understanding
any accompanying family members’ access to settlement
PA – Principal Applicant
services; and,
• The employer understands and agrees to the reporting NOC – National Occupational
requirements for the program. Classification

Please complete this form if you are interested in being designated to PR – Permanent Resident
participate in the Atlantic Immigration Program. You are required to SPO – Service Provider Organization
complete this designation once. Future use of the program will be
supported by your initial designation, provided it remains valid. TFW – Temporary Foreign Worker

*Please note that home-based businesses and businesses located in

residential homes may not be eligible for designation.

Mandatory training with Immigration, Refugees and Citizenship Canada is required in order to endorse
candidates under the program. Please note that you may register for and complete this training at any stage
prior to applying for your first endorsement. To register for the mandatory training please follow this link:

EN: Canada.ca/atlantic-immigration-employer-training

FR: Canada.ca/immigration-atlantique-formation-employeur

Please refer to the Guidelines for Designation and Endorsement for further information on completing this form.

Employer Designation Application – Atlantic Immigration Program (February/2022) Page 1 of 10

 EMPLOYER DETAILS

________________________________________________ ________________________________________________
Company Legal Name Operating as (if applicable)

________________________________________________ ________________________________________________
Name of primary authorized signing officer Name of secondary authorized signing officer
(if applicable)

________________________________________________ ________________________________________________
Position within company Position within company (Secondary, if applicable)

(_____)_________________________________________ (_____)_________________________________________
Telephone Telephone (Secondary, if applicable)

________________________________________________ ________________________________________________
Email Email (Secondary, if applicable)

________________________________________________ ________________________________________________
Name of delegated contact Delegated contact’s email

________________________________________________ (_____)_________________________________________
Delegated contact’s position within company Delegated contact’s telephone

________________________________________________
Two-digit code(s) of business sector under the North American Industry Classification System (NAICS)

_________________________________________________________________________________________________________________________
CRA Business Number

_________________________________________________________________________________________________________________________
CADO Number (Companies and Deeds Online Number)

_________________________________________________________________________________________________________________________
Company Website

Have there been any complaints, investigations or decision(s) against your company including, but not limited
to decisions under: Provincial labour standards/Federal labour standards/Occupational Health and
Safety/Human Rights/Immigration, Refugee and Protection Act (IRPA) or Immigration, Refugee and Protection
Regulations (IRPR)?

☐ Yes ☐ No

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If yes, please provide an explanation:

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

COMPANY DESCRIPTION

Year the company established in the province: ___________________

Number of years in continuous active operation in the province: ________________

Number of years in continuous active operation under current management: ______________

Total Number of Employees at the time of application: __________

Full Time Employees: _________ Part Time Employees: _________

Are you designating more than one location? ☐ Yes ☐ No

If yes, more information may be requested by Newfoundland and Labrador

Does your company have an approved Labour Market Impact Assessment (LMIA): ☐ Yes ☐ No

Does your company employ Temporary Foreign Workers with valid LMIA-exempt work permit? ☐ Yes ☐ No
If yes, provide the number of Temporary Foreign Workers with a valid work permit (not PRs/Canadians):

Number with LMIA: ___________

Number of LMIA-exempt: ___________

Describe your company’s purpose and activities:

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

Is your business registered or operating from a residential address: ☐ Yes ☐ No

Employer Designation Application – Atlantic Immigration Program (February/2022) Page 3 of 10

If yes, please describe the primary activities taking place at this location.

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

Is your business or any of your employees located in a temporary or shared (hub) space? ☐ Yes ☐ No

If yes, please describe your plans to supervise the employee and foster a welcoming workplace. Also describe
your business’ long term plans for workspace.

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

LABOUR NEEDS

The province must be satisfied that your business has the financial and other resource capacity to retain new
hires for the duration of their contracts and may request additional information to validate this capacity.

Describe the labour gaps in your company and why you are considering hiring one or more candidate(s)
through the Atlantic Immigration Program to address your labour needs.

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

To date, what methods have you used to recruit for these positions?

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

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Please indicate in the table below the details of the position(s) you are planning to fill in each of the following
three years, and the location for this employment. Designation for more than one location may be considered
if all locations meet the eligibility criteria of the program. We understand that this information may be
approximate.

Year 1: 2022
Job title # of positions NOC Wage rate

Business location Location contact person

Street Address: Name:
Community: Title:
Postal Code: Email:
Job title # of positions NOC Wage rate

Business location Location contact person

Street Address: Name:
Community: Title:
Postal Code: Email:

Year 2: 2023
Job title # of positions NOC Wage rate

Business location Location contact person

Street Address: Name:
Community: Title:
Postal Code: Email:
Job title # of positions NOC Wage rate

Business location Location contact person

Street Address: Name:
Community: Title:
Postal Code: Email:

Year 3: 2024
Job title # of positions NOC Wage rate

Business location Location contact person

Street Address: Name:
Community: Title:
Postal Code: Email:
Job title # of positions NOC Wage rate

Business location Location contact person

Street Address: Name:
Community: Title:
Postal Code: Email:

Employer Designation Application – Atlantic Immigration Program (February/2022) Page 5 of 10

Are these vacancies a result of business expansion or are they currently unfilled positions within your
organization?

☐ Expansion ☐ Current unfilled positions

Please explain: _________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

USE OF A REPRESENTATIVE

If designated, employers must be diligent if using the services of an immigration representative, third-party
recruiter, or recruitment/placement agency to hire employees. Employers must follow fair recruitment
practices, be cautious in their hiring practices and respect applicable laws regarding the use of representatives
and recruiters, where they exist.

If you used the services of an immigration representative, paid or unpaid, complete the following:

________________________________________________________________________________________________________
Company name Representative

________________________________________________________________________________________________________
Mailing address, including postal code

(_____)__________________________________________________________________________________________________
Telephone Email Website

If you used the services of recruitment agency, paid or unpaid, complete the following:

________________________________________________________________________________________________________
Recruitment Agency Representative

________________________________________________________________________________________________________
Mailing address, including postal code

(_____)__________________________________________________________________________________________________
Telephone Email Website

COMMITMENT TO SETTLEMENT SUPPORTS

Please refer to the Employer Designation Guidelines for information on the settlement commitments you are
agreeing to make to candidates recruited by you under the Atlantic Immigration Program.

Collaboration with an immigrant settlement service provider organization: Indicate the name and contact
information of the Settlement Service Provider you contacted to familiarize yourself with the settlement services
available in your community. If the preferred service provider in your community/region is not on the attached
list, please provide details and explanation.

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_______________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

INTERCULTURAL COMPETENCY TRAINING

Employers hiring newcomers through the Program commit to fostering welcoming workplaces. Intercultural
competency training can help you to take meaningful steps to welcome and integrate your newcomer
employee(s), which will help you to retain internationally-trained talent in the long term. As such, each
employer – preferably a senior manager may be expected to complete intercultural competency training
before they can endorse candidates through the Program.

Have individuals in senior management positions in your organization completed an intercultural competency
training course in the past two years? To qualify, the training should be 3-4 hours in length, and cover the
following topics: Creating Welcoming and Culturally Inclusive Workplaces, Newcomer Experiences, Culture.

☐ Yes ☐ No

If yes, please attach proof of completion of the training to your designation application (e.g. a certificate of
completion, invoice, etc.) which includes the name of the training provider and the date the training was
completed:

If your organization has in-house training that covers the same topics, please provide details below:

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

If no, register for intercultural competency training at a service provider free of charge. Please refer to the
attached list for training service providers in your area. You will need to provide proof of completion of
intercultural competency training when you apply to endorse your first candidate.

EMPLOYER DECLARATION

As the employer:

*please initial on line beside each statement*

 I agree to identify and hire qualified candidates.

 I agree to apply for an endorsement from the Government of Newfoundland and Labrador for any
candidate I am prepared to hire under the Atlantic Immigration Program, and accept the terms and
conditions of the endorsement application.

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 I will provide a full-time, non-seasonal, genuine offer of employment to employees brought in to Atlantic
Canada through this program.

 I agree to cover the costs associated with a temporary work permit holder’s return to their country of
origin, where that individual would have applied for the NOC C level and where this designation has
been revoked and Newfoundland and Labrador is unable to find the individual(s) alternate employment.

 I agree to report on the number of candidates recruited under the Atlantic Immigration Program, their
employment status, details on their position/wage/hours, and the settlement supports provided to them
for up to three years after you hired them, or the duration of their employment if less than three years.

 I agree to comply with the IRPA, IRPR, the province’s labour standards and Occupational Health and
Safety legislation as well as applicable Federal labour legislation for federally regulated companies.

 I agree to fulfil my obligations to collaborate with an immigrant settlement service provider organization,
ensure that the workplace is welcoming to newcomers, and provide support to access settlement
services for candidates and their accompanying family member(s) which may include providing or
paying for services that are not otherwise available as stated in the commitment to settlement supports,
as in the Designation Application Guidelines.

 I agree to provide further information as requested by the Government of Newfoundland and Labrador.

 I understand that any violation of IRPA or IRPR will result in my employer designation being revoked.

 I understand that any non-compliance with any federal or provincial legislation, or with the terms and
conditions of the Atlantic Immigration Program may result in probation, suspension or termination from the
Atlantic Immigration Program.

 I commit to taking the mandatory onboarding training provided by Immigration, Refugees and Citizenship
Canada (IRCC).

 I commit to taking intercultural competency training, where the Government of Newfoundland and
Labrador has deemed it appropriate or necessary.

 I agree to immediately notify the Government of Newfoundland and Labrador of any complaint,
investigation or decision under IRPA, applicable labour codes, employment or health and safety
standards or non-compliance with the terms of the Atlantic Immigration Program.

 I agree to immediately notify the Government of Newfoundland and Labrador, in writing, if there are any
changes in the ownership structure of the company, if the company is sold or if it closes, permanently or
temporarily and if any changes occur with the position offered.

 I agree to immediately notify the Government of Newfoundland and Labrador, in writing if the candidate
quits, is terminated or is laid off from their position.

 I declare that I will meet the above commitments outlined in this employer declaration, and that the
information given in this form is truthful, complete and correct.

☐ Yes ☐ No
*Failure to agree to the above terms of this Declaration will make you ineligible for the Atlantic Immigration
Program.

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By signing, I authorize the Government of Newfoundland and Labrador to collect, use, retain, disclose, and
destroy personal and business information for the Atlantic Immigration Program. If I have any questions about
the collection, use, retention, disclosure, or destruction of personal and business information, I may contact the
Government of Newfoundland and Labrador. In addition, I authorize the Government of Newfoundland and
Labrador to research, monitor, and evaluate the Program under the authority of the Newfoundland and
Labrador’s Access to Information and Protection Privacy Act, 2015, the Immigration and Refugee Protection
Act, and Regulations, and other relevant Government of Canada legislation.

I authorize immigration officials within the Government of Newfoundland and Labrador to disclose personal
and business information to the Government of Canada and to collect personal and business information from
the Government of Canada as necessary for the purpose of assessing, verifying information, monitoring and
evaluating the Atlantic Immigration Program or in the event of a suspected non-compliance with any
provincial or federal law.

I authorize immigration officials with the Government of Newfoundland and Labrador to disclose personal and
business information to other Canadian provincial and territorial immigration officials, and to collect personal
and business information from other Canadian provincial and territorial immigration officials, as necessary, for
the purpose of assessing, verifying information, or in the event of any suspected non-compliance with provincial
or federal law.

I understand that the Government of Newfoundland and Labrador may contact any person to verify
information provided by me in this form.

I consent to the Government of Newfoundland and Labrador collecting, using, disclosing or destroying any
personal, business and other information required as part of my company’s involvement in the Atlantic
Immigration Program for the purpose of evaluating the program and our participation in it.

I authorize the Government of Newfoundland and Labrador to locate and contact me and my company for
the purposes of administering and evaluating the program and our participation in it, to verify information
provided to the Government of Newfoundland and Labrador and to ensure compliance with commitments
made to the Government of Newfoundland and Labrador in this application or otherwise.

I consent to the Government of Newfoundland and Labrador collecting, using, disclosing or destroying any
personal, business and other information it obtains from me or from any federal, provincial, municipal or other
local authority or any other person, department, agency or organization holding such information.

I have read, reviewed, acknowledge, agree and accept responsibility to the terms, requirements, and
conditions set out in the Atlantic Immigration Program Designation Application Form and Guidelines.

______________________________________
Name of Authorized Signing Officer

_______________________________________
Signature of Authorized Signing Officer

______________________________________
Title

______________________________________
Date (dd/mm/yyyy)

Employer Designation Application – Atlantic Immigration Program (February/2022) Page 9 of 10

 SUBMITTING THIS APPLICATION

Please submit the completed form to:

Email: [email protected]

QUESTIONS

Please contact the Government of Newfoundland and Labrador’s Office of Immigration and Multiculturalism
by phone at (709) 729-6607 or via email at [email protected] if you have any questions.

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