Customer Service CARES Application Form

This application form is for the Centre for Newcomers and Women In Need Society's Customer Service CARES Program. If you have questions please call: Centre for Newcomers at (403) 569-3325 or Women In Need Society at (403) 819-0087.

Today's Date *

How did you hear about Customer Service CARES? *

Which program dates are you applying for? *

January 3, 2022 - January 28, 2022 February 28, 2022 - March 25, 2022 May 2, 2022 - May 27, 2022

Last Name *

First Name *

Address *

Street Address

Street Address Line 2

City

Postal / Zip Code

Phone Number *

Email *

example@example.com

Country of Origin *

Primary First Language *

Arabic English Spanish Amharic Chinese Vietnamese Tigrinya Tagalog Other

What is your status in Canada currently? *

Permanent Resident Refugee with Work Permit Canadian Citizen Refugee without Work Permit Temporary Foreign Worker

What is your source of income? *

Savings Part-time job Family Income Other

Provide your Canadian Language Benchmark (CLB). If you are not sure, please select "Unsure" below. *

CLB 1-2 CLB 2-3 CLB 3-4 Unsure

Choose below which best describes your ability to speak and understand English *

Able to speak and understand Have difficulty speaking but able to understand instructions Able to speak but needs help with understanding instructions

Canadian Work Experience - Please provide employment information on your last job(s) in Canada. If you have no Canadian work experience, leave this blank