Youth Employment Centre Intake FormPlease enable JavaScript in your browser to complete this form.Name *PhoneEmail *Date of Birth *Gender *FemaleMaleOtherPrefer to not discloseDo you have any children? *YesNoNumber of DependantsWhich languages do you speak? *EnglishFrenchOtherPlease identify other languages:Do you identify as any of the following: *First NationNon-First NationInuit/MetisOtherEducation, Training & CertificatesAre you currently in school? *YesNoWhat school are you attending?What is your highest level of education? *What Training/Certificates do you have? *Do you have a valid drivers licence? *YesNoWhat class of drivers licence do you have?What training would make you more employable?Employment & IncomeAre you employed? *EmployedSelf-EmployedUnemployedFull-time StudentWhere are you employed?What do you do?Are you receiving any of the following?Employment InsuranceStudent Financial AssistantIncome SupportWhat type of work are you looking for?What have you done to find work?What are your career goals?DeclarationI declare the information I provided to the Skookum Jim Friendship Centre, Youth Employment Centre is true, correct & complete to the best of my knowledge. The financial support sought will be used solely for training or employment purposes described on this application. I understand that I will be liable for criminal proceedings or for full payment to the Skookum Jim Friendship Centre, Youth Employment Centre of my training/employment fees. I hereby give permission to the Skookum Jim Friendship Centre, Youth Employment Centre to verify information on this application. I will immediately notify the Skookum Jim Friendship Centre, Youth Employment Centre if I choose to withdraw from my program. This information is protected under the Privacy Legislation & will be used for the administration of case management, contract monitoring & accountability.Signature *Clear SignatureDateSubmit Downloadable Form Skookum Jim Friendship Centre Intake FormPDF