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In the area below, please tell us who you are and how we can reach you.
Last Name: First Name:

Address: City: Prov./Terr.: Postal Code:

Area Code: Phone Number: Email:

Sign up date:(month/day/year)
Please indicate group(s), check more than one if applicable:

m Aboriginal m Social Assistance Recipient Age Range:

m Visible minority m New Immigrant m 17 and under

Country of origin: m 18-29
m Person with disability m Other (please specify) m 30 and above

Please tell us about your skills and experience.

1. Indicate below the HIGHEST level of education you have achieved so far.

m primary school m partial high school m high school diploma m some college/CEGEP

m college/CEGEP m partial university m university degree m other (please specify)


2. If at all, please tell us how long you have been without a full-time job during the past 24 months?
m not applicable m 1-4 months m 5-9 months m 9-14 months m over 14 months

3. Prior to participating in this program, were you receiving any of the following forms of government assistance?
m unemployment insurance m Social Assistance m not applicable m other (please specify)
(i.e. Welfare)

4. I am currently: (please check one only)

m in high school m attending college/ m unemployed m employed and studying
university full-time part-time

m employed part-time m employed full-time m Other (please specify)

5. I first learned about the Ready-to-Work program from:

m a school counsellor m Human Resources Centre/Youth m ad in a newspaper m recruitment posters

Service Centre
m Tourism Education m friend/family m web site (www) m other (please specify)

Privacy Statement: The Canadian Tourism Human Resource Council (CTHRC), its partners the Tourism Education Councils (TECs) and program funders are committed
to respecting the personal privacy of individuals who provide information on Ready-to-Work forms. The purpose of collecting the personal information requested in this
form is to capture your contact information as well as prior skills/experience for statistical purposes. By signing this form on the space indicated below, you consent to the
use of the personal information that you have provided for that purpose. Your personal information, as provided, will only be shared with the CTHRC staff and its partners
and will not be disclosed to third parties without your consent. For more information on the CTHRC privacy policy please visit or call (613) 231-6949.
Would you agree to have your name released to an independent research company to participate in a follow-up evaluation of this program? Your response to this follow-up
evaluation will be kept strictly confidential.
m yes m no
Participant Signature:

* Thank you and good luck! *