Times Change Employment Services Registration
Name
*
First Name
Last Name
Gender
*
Female / Identify as Female
Male
Other
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
1. Do you already have an employment counselor at Times Change?
*
No
Yes
Who is your employment Counselor?
*
Lydia Stouten
Karen Hoffmann-Zak
Shiva Maleki
Denise Alves
Other
2. Service(s) I am interested in:
*
Interactive Online Resume workshop
Interview Skills Workshop
Job Search Strategies Workshop
Other
3. Are you working right now?
*
Yes
No
If YES, how many hours a week on the average do you work right now?
average # of hours/week
4. Are you a full-time student?
Yes
No
5. Are you job searching?
*
Yes
No
If YES, what kind of work are you looking for?
6. What is your status in Canada?
Permanent Resident
Canadian Citizen
Convention Refugee/Protected Person
Refugee Claimant
Other
7. Have you received job search assistance from any other agency? Do you remember if you gave them your SIN number
Yes
No
If yes, name of agency
name of agency
8. How did you hear about us?
*
Please Select
Facebook
Community Referral
Word of Mouth
Google
Library
Doctor/Social Worker
Other
9. Optional - Please attach a copy of your most current resume if you have one
Browse Files
Cancel
of
9. Question/Additional Information
Submit
Should be Empty: