SDF5 - Employer Registration Form

Skills Development Fund Training Stream (SDF-TS) Employer Registration

This form is required ONLY for those SDF-TS projects with Employers. Sections marked with an asterisk (*) are mandatory. If the "Same as " or "Not applicable" box is checked please move directly to the next section.
Date of Registration*

MonthDayYear
Date

Registered/Corporate Information
Registered/Legal Name*
Corporate Business Name (hereinafter referred to as the "Employer")*
Canada Revenue Agency/Business Number*
Total Number of Employees in Corporation (Registered Corporation)
Year Business Registered:
Enter the full year. Example: 1995, 2006
Preferred Language*

EnglishFrench
Preferred Method of Communication

PhoneEmailHard Copy

Corporate Address
Unit Number
Street Number*
Street Name*
PO Box
City/Town*
Province*
Postal Code*
Closest Intersection*
Corporate Telephone Number*
ext.
Corporate Fax
ext.

Mailing Address
Is your Mailing Address the same as your Corporate/Business Address?

Yes
If your Mailing Address is different from your Corporate/Business Address, please fill in the fields below.
Unit Number
Street Number
Street Name
PO Box
CityTown
Province
Postal Code
Closest Intersection

Primary Corporate Contact Details
Name*

First NameMiddle InitialLast Name
Title
Email Address
example@example.com
Phone Number*
ext.
Fax Number
ext.

Alternate Corporate Contact Details
Not Applicable?

Yes
Name

First NameMiddle InitialLast Name
Title
Email Address
example@example.com
Phone Number
ext.
Fax Number
ext.

Business (Local Branch) Information
Is your Business (Local Branch Information) the same as your Registered/Corporate Information?

Yes
If your Business (Local Branch Informatio)n is different from your Corporate/Business Information, please fill in the fields below.
Unit Number
Street Number
Street Name
PO Box
City/Town
Province
Postal Code
Closest Intersection

Primary Branch Contact Details
Is your Primary Branch Details the same as your Registered/Corporate Information?

Yes
If your Primary Branch Information is different from your Corporate/Business Information , please fill in the fields below.
Name

First NameMiddle InitialLast Name
Title
Email Address
example@example.com
Phone Number
ext.
Fax Number
ext

Alternate Branch Contact Details
Not Applicable?

Yes
Name

First NameMiddle InitialLast Name
Title
Email Address
example@example.com
Phone Number
ext.
Fax Number
ext.

Placement Position 1
If you are receiving the wage subsidy for 2 apprentices, please complete both Placement Position 1 and Placement Position 2.

If you have only 1 apprentice, you DON'T need to complete Placement Position 2.
Placement Site Address 1
Placement Site Address

Same as Corporate AddressSame as Branch Address (if different from Corporate)
Unit Number
Street Number
Street Name
PO Box
City/Town
Province
Postal Code
Phone Number*
ext.
Fax Number
ext.
Email Address
example@example.com
Placement Information 1
Placement Position Title (Trade Code)*
Placement Position Title (Trade Code)
Number of Available Positions*
Placement Start Date*

MonthDayYear
Date
Scheduled Days:

Monday - Friday
Hours of Work*
Rate of Pay (per Hour)*
NOC*
NAICS*
Brief description of the placement(s) available
Description of the duties and components of the placement(s)
Basic skills required for the placement(s)
What training are you providing to the participant(s)
Other Requirements (if any)
Are you receiving any other government funding associated with the employment/training of participants?*

YesNo
If Yes, specify

Placement Position 2
Placement Site Address 2
Placement Site Address

Same as Corporate AddressSame as Branch Address (if different from Corporate)
Unit Number
Street Number
Street Name
PO Box
City/Town
Province
Postal Code
Phone Number
ext.
Fax Number
ext.
Email Address
example@example.com
Placement Information 2
Placement Position Title (Trade Code)
Number of Available Positions
Placement Start Date

MonthDayYear
Date
Scheduled Days:

Monday - Friday
Hours of Work
Hours of Work
NOC
NAICS
Rate of Pay (per hour)
Brief Description of the placement(s) available
Description of duties and components of the placement(s)
Basic skills required for the placement(s)
What training are you providing to the participant(s)?
Other Requirements if any
Are you receiving any other government funding associated with the employment/training of participants?*

YesNo
If Yes, please specify

Declaration and Signature
Declaration and Signature

Note: Providing false or misleading information in this form may result in the refusal of the application, or in the termination of any agreement entered into following approval of the application.
This certifies that the Employer:
- is licensed to operate its business in Ontario;
- provides training in Ontario which is related to a job that is located in Ontario;
- complies with the Occupational Health and Safety Act and the Employment Standards Act;
- maintains appropriate Workplace Safety and Insurance Board or private workplace safety insurance coverage;
- has adequate third-party general liability insurance as advised by my insurance broker;
- complies with all applicable federal and provincial human rights legislation, regulations, and any
- if in receipt of other funds (government or otherwise) related to the same skills training for the same individual, funds must not exceed the total cost of wages paid to the participant; and
- will not use training participants to displace existing staff or replace staff who are on lay-off.
NOTE: Intentional falsification of information on this form may lead to termination from Skills Development Fund Training Stream.
I am authorized to act on behalf of the Employer and the information on this form is complete and accurate.

Yes
I am authorized to act on behalf of the Employer and the information on this form is complete and accurate.*

Yes
Name

First NameLast Name
Name*

First NameLast Name
Title
Title*
Date

MonthDayYear
Date
Date*

MonthDayYear
Date
Assessment of Training Opportunity / Worksite:
Please add email to receive submission confirmation (optional)
example@example.com
Should be Empty:

Skills Development Fund Training Stream (SDF-TS) Employer Registration

Declaration and Signature