2025-2026 | Urban Circle Application Form

Adult Education & Employment Program

Student Application Form | 2025-2026
The Adult Education & Employment Program is funded by the Adult Learning and Literacy Branch of Manitoba Advanced Education and Training (ALL) and Neeginan Education, Training and Employment Services, Inc. (NETES), and in partnership with Seven Oaks School Division.

All applications must be accompanied with the following:
1. Two (2) current character reference letters from professional working people who know you. (i.e., former employer, coworkers, teachers, supervisors, counsellors, volunteer supervisors, etc.)
2. A hand-written autobiography that details why you want to take this program. In this paper, state your goals and tell us about yourself.
3. A copy of original high school transcripts to verify previous education. Please contact the last school you attended to obtain this document.
Please Note: Students may be required to submit an original and current criminal record check, child abuse registry check, and adult abuse registry check prior to commencing work placement.
Personal Information

This information helps us contact you and keep our records accurate.
Student Name

First NameMiddle NameLast Name
Preferred Name
Birth Date

MonthDayYear
Address

Street Address

Street Address Line 2

CityProvince

Postal Code
Student E-mail
example@example.com
Mobile Number
Format: (000) 000-0000.
Alternate Phone Number
Format: (000) 000-0000.
Social Insurance Number
Ex. 999 999 999
Gender Identity
Parental Status
Indigenous Status
Please Indicate:

Contact Person

Please provide us with the information of a friend or family member where you can be contacted.
Contact Person Full Name
Eg. Vladimir Guerrero
Relationship to You
Eg. Mother, Partner, Colleague, Worker, etc.
Contact's Address
Eg. 123 Any Street, Winnipeg
Contact's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Contact's Email Address
example@example.com

Child Care

These details help us understand your childcare needs so we can support you in planning for full program attendance. If child care is required, child care arrangements MUST be made by the student.
Please indicate your current arrangements below:

Criminal Record Check

Should you have a criminal record with convictions, you must obtain the criminal record transcript which outlines all of your charges. The transcript must be submitted to urban Circle Training Centre, Inc. prior to acceptance into the program. If assistance is required, we would be glad to help.
Do you have a criminal record with convictions?
If yes, please provide details about the charge(s) and indicate how long ago they occurred.

Education & Training Assessment

The following questions help us understand your funding history and current supports, so we can ensure you have the resources needed to succeed in this program.
Have you been referred to Training & Employment Services by your EIA worker?
Have you applied for funding from your Band, Education Council, Manitoba Métis Federation, or another organization?
If yes, please provide the following information:
Have you ever received funding support from any organization in the past?
If yes, please provide the following information:

Education & Training

The following questions help us understand your education background and any additional training you may have completed, so we can place you at the right level and provide the supports you need.
Highest Level of Education Completed
i.e., Grade 11, Grade 8, etc.
Name of Last School / Learning Centre Attended
i.e., Children of the Earth, Jobworks, etc.
Have you had any additional training? (i.e., College, University, On-the-Job, School Placements, etc.)
If you did not complete your education or training, please explain why:
If you are not currently working in the field you trained for, please explain why:

Additional Client Information

This section gives us a better picture of your circumstances so we can plan supports as needed.
Do you identify as a person with a disability?
What is your marital status?

Volunteer Experience

Sharing volunteer or unpaid work experience helps us understand the skills and experiences you bring to the program.
Do you have volunteer or unpaid work experience?
If yes, please provide the following information:

Referral Source

This information helps us understand how applicants are learning about Urban Circle and who may be supporting their application.
How did you first hear about Urban Circle Training Centre?
Were you referred by someone (e.g., counsellor, case worker, organization)?
If yes, please provide:

Privacy Notice & Consent

Summary: Urban Circle Training Centre (UCTC) collects personal information only to support your application, funding, and success in the program. This may include sharing information with schools, funding agencies, or government departments when required. Your information will always be handled with confidentiality and respect.
Full Privacy Statement
UCTC needs to collect and use your personal information and personal health information, if applicable, for the following purposes:
- To assess your training needs.
- To monitor and record your enrolment, participation, and progress.
- For research, planning, reporting, monitoring, evaluation, and accountability purposes.
I consent to Urban Circle Training Centre Inc. (UCTC) collecting personal information and personal health information, if applicable, about me for the purposes of assessing training needs from the persons and bodies listed below and consent to UCTC providing such information about me as necessary to obtain the information UCTC requires. I consent to the persons and bodies disclosing the information to UCTC:
- Details about me in relation to gaining entrance into one of UCTC’s programs.
- My availability.
- Any organization, agency, or entity that has provided me with work experience or training.
- My schools and educational/training institutions.
- Any Manitoba (MB) government department or agency, or federal government department or agency, that has provided or is providing me with services or assistance, including Employment and Social Development Canada, Service Canada, MB Education and Training; MB Health, Seniors, and Active Living; MB Families; MB Growth, Enterprise and Trade; MB Justice; MB Indigenous and Municipal Relations; and Crown Services.
Urban Circle Training Centre Inc. (UCTC) works with employers, service providers, educational institutions, municipal, provincial, and federal government departments and agencies to provide a broad range of training and employment services to eligible participants.
I, blanks (enter full name), certify that the statements made by me in this application are true to the best of my knowledge. I consent to the Urban Circle Training Centre Inc. (UCTC) Interview Team verifying any information supplied by me (unless otherwise indicated) for the purpose of ensuring my suitability for the program. I also agree to provide UCTC with any changes to my personal information and personal health information, if applicable, as circumstances arise, in a timely manner.
Signature
Date

MonthDayYear
Date
Should be Empty:

Adult Education & Employment Program

Personal Information

Contact Person

Child Care

Criminal Record Check

Funding & Financial Information

Education & Training Assessment

Education & Training

Additional Client Information

Volunteer Experience

Referral Source

Privacy Notice & Consent