Applicant Skills for Success Practioner Certification Registration

Skills for Success Practitioner Certification Registration

Applicant
Date of Application*

MonthDayYear
Date
Name*

First NameLast Name
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Mobile Number
Please enter a valid phone number.
Email*
example@example.com
Birth Date*

MonthDayYear
Date
Applying for Cohort*

Cohort 5

Cohort Training Dates

Cohort 1

Part 1	May 18, 19, and 20, 2022	Winnipeg
Part 2	May 31, June 1, and 2, 2022	Winnipeg
Part 3	June 13, 14, and 15, 2022	Winnipeg
Part 4	June 27, 28, and 29, 2022	Winnipeg

Cohort 2

Part 1	January 17, 18, and 19, 2023	Calgary
Part 2	January 31, February 1 and 2, 2023	Saskatoon
Part 3	February 7, 8 and 9, 2023	Toronto
Part 4	March 7, 8 and 9, 2023	Charlottetown

Cohort 3 and 4

Self-directed online learning with mentor support and practicum.

Cohort 5

Self-directed online learning with mentor support and practicum.
Start immediately after receiving the acceptance email.

Proof of Credentials

Upload Materials
Certificates (most recent)

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Diplomas

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Micro-credentials (most recent)

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Post-secondary

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Minimum three years of training, consulting, mentorship, program management, design or development.

YesNo
Languages

EnglishFrenchOther
Other
Upload Resume

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Experience in topic areas. Skills for Success.

AdaptabilityCollaborationCommunicationCreativity and InnovationDigitalNumeracyProblem SolvingReadingWriting
Experience in topic areas. Relational Skills

Change and Continuous LearningCultural CompetenceCommunications in the New World of WorkResilience and Growth MindsetCivility and CitizenshipSystems ThinkingSocial IntelligenceCollaboration
Willing to commit to full participation in completing the certificate criteria.

2 Exams (100 and 40 multiple choice questions open book exams; these are pass/fail with 85% score required)200 hours of coursework and practicum over 12 months (time includes self-directed online study, required and recommended reading, optional mentorship, practicum preparation, delivery, and reporting, and exam preparation)
Social Media Links
Twitter
Facebook
LinkedIn
YouTube
Instagram
Tik Tok
Pinterest
Sample of training material you have created or delivered. (Content will not be shared and you retain your copyright)

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Submit Three Work References
Work Reference
Work Reference
Work Reference
Reason for interest in Skills for Success (200 word statement)
Decribe a scenario where you used any one of the Skills for Success in the workplace (300 maximum work statement)
Submit one unique idea or approach for teaching one of the Relational Skills at work. (300 words maxium)
Willingness to submit, upon approval of preliminary application, evidence of citizenship, criminal record check, vulnerable persons check, and confidentiality agreement.*

YesNo
MEDIA CONSENT

Workplace Education Manitoba may undertake recording training sessions in the interests of improving delivery standards. As part of my participation, I herby consent to interviews, the use of quotes and the taking of photographs and/or audio/videos during the training sessions. I also grant Workplace Education Manitoba the right to edit, use, and reuse my likeness in print, online, social media and all other forms of media to promote future training. I give this authorization without expectations of compensation.

This consent will remain in effect until I revoke it in writing.
I agree with Media Consent*

YesNo
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Skills for Success Practitioner Certification Registration

Proof of Credentials

Social Media Links

Submit Three Work References