Customer Service CARES Application Form

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*

MonthDay Year
How did you hear about Customer Service CARES?*
Which program dates are you applying for?*

January 3, 2022 - January 28, 2022February 28, 2022 - March 25, 2022May 2, 2022 - May 27, 2022
Last Name*
First Name*
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number*
Email*
example@example.com
Country of Origin*
Primary First Language*

ArabicEnglishSpanishAmharicChineseVietnameseTigrinyaTagalogOther
What is your status in Canada currently?*

Permanent ResidentRefugee with Work PermitCanadian CitizenRefugee without Work PermitTemporary Foreign Worker
What is your source of income?*

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

CLB 1-2CLB 2-3CLB 3-4Unsure
Choose below which best describes your ability to speak and understand English*

Able to speak and understandHave difficulty speaking but able to understand instructionsAble 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
Should be Empty: