First Name
*
Last Name
*
Email
*
Phone
*
Date of birth
*
Gender Identity
*
Male
Female
Non binary
Prefer not to say
Marital Status
*
Married
Unmarried
Number of dependants
*
Zero
One
Two
More
Address
*
City
*
Postal code
*
I agree to
terms & conditions
provided by the company. By providing my phone number, I agree to receive text messages from the business.
Legal Status in Canada
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Permanent Resident
Citizen
Refugee protected with court’s decision
When did you immigrate to Canada?
*
Employment Status
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Full-Time Employed
Part-Time Employed (less than 20 hours a week)
Part-Time Employed (more than 20 hours a week)
Casual/On Call
Unemployed
Are you willing to complete 12 weeks in person training at ATTI college surrey campus (9486 120 St Unit 101, Surrey, BC V3V 4B9) ? (9AM-2:30 PM)
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Yes
No
Do you have any of the following?
*
Active Employment Insurance
BCEA PWD
BCEA Non-PWD (Income Assistance/ Welfare)
None of the above
Pick one of the Field/ Industry you are interested In
*
AUTOMOTIVE COHORT
Do you belong to any of the following demographics of equity deserving group.
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Women
2SLGBTQIA+
Immigrants*
Black Canadians
Racialized Persons
Young Adult at Risk
Indigenous People
What's your Ethnicity?
*
American Indian or Alaska Native
Asian
North Africa
Black or African
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
Caucasian
Other
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Do you have a laptop?
*
Yes
No
I will arrange
Do you have prior experience working in the trades?
*
Yes
No
If yes, please specify
How did you hear about this program?
*
WorkBC Center
Whatsapp/Facebook group
PICS websites
Ace Trades and Technical Institute (ATTI)
Internet
Previous Client
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Emergency Contact (Full Name)
*
Emergency Contact Number
*
Relationship
*
Emergency Contact (Full Name) 2
*
Emergency Contact Number 2
*
Relationship
*
Upload Resume
*
Upload Government Picture ID with proof of age of 19+
*
Consent
*
Your personal information will be collected for determining your potential to participate in this project. If you have any questions about the collection of this personal information, please contact PICS Vancouver Office at 604-324-7733 or surrey office 604-596-7722. This information is being collected by Progressive Intercultural Community Services Society under Freedom of Information and Protection of Privacy Act (FOIPPA), section 26." I accept to be added to the waiting list of applications, and understand that my application will be reviewed and assessed on a first come first served basis. I, authorize Progressive Intercultural Community Services Society (PICS), any other service providers, schools, and community agencies to disclose/exchange my personal information, including the usage of my photo and /or video in the following: (1) Information regarding my training, employment history, and needs. (2) Information regarding my progress and follow-up results. (3) Attendance at scheduled interviews and interventions at the above agencies. (4) Information regarding marketing of the program. 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. I agree to also receive marketing and promotional emails and newsletters from PICS regarding upcoming education and training programs.
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