Building Opportunities with Business

Referral Agency Information

Employment Counsellor Name *

Referral Agency *

Email Address *

Phone * - -

Case Manager Information

Does the applicant have a Service Canada case manager? Please Select Yes No

If info is different from above, please complete:

Manager Name

Email Address

Phone - -

If the applicant does not have a Case Manager: we recommend that you refer them to a Service Canada location as well. As we are funded through Service Canada, all Supported Employment Program (SEP) participants need to be case managed. Our SEP program gives participants access to post employment support, services, and resources.

Applicant's Information

Applicant Name *

Company *

Position/Training Applying For *

Attending Industry Night * Please Select Yes No

This candidate is qualified/suitable for this position because *

Resume*

Cover Letter*