Job Start Application

* Are between the ages of 15 and 30? Yes No

* Are you in need of assistance to overcome barriers to employment? Yes No

Barriers to employment can include:

• single parenting
• poor work retention and/or behavior management
• visible minority
• Aboriginal descent
• disabilities; including learning challenges
• recent immigrants
• living rural and remote areas
• grade 12 or less
• no source of income
• lack of social supports (family/friends)
• out of school or work for 6+ months
• past involvement with justice/addictions/homelessness

* Are you currently out of school (less than 12 hours a week)? Yes No

* Are you currently out of work or working less than 12 hours a week? Yes No

* Are you legally entitled to work in Canada? Yes No

* Are you currently in receipt of Employment Insurance (EI) benefits or have been in the last 3 years? Yes No

* Do you have a Social Insurance Number (SIN) or have you applied for one? Yes No

* First Name:

* Last Name:

* Street Address:

* City:

* Province:

* Postal Code:

* Phone:

Alternate Phone:

* Email:

Gender:

* Date of Birth:

What is your highest level of education completed? Did Not Complete High School High School Some Post Secondary Completed Post Secondary

Are you currently working with an Employment Counsellor/Advisor? Yes No

If so, who?

Once you submit your application, a KEYS team member will connect with you in the next two business days to get started on supporting you with your job search!