HCA Training Program - Basic Eligibility Pre-Screen

1
Name* This field is required.
First Name
Last Name
2
Phone Number* This field is required.
Please enter a valid phone number.
3
Email* This field is required.
example@example.com
Confirm Email
4
Who is your current seniors' care employer?(Leave blank if not currently working in the field)
5
Do you reside in British Columbia (B.C.)?* This field is required.
YESNO
6
City (Please select only the city where you are currently located)* This field is required.IMPORTANT NOTE: Recruitment is limited to applicants based in the Port Alberni and Cowichan Valley region. Applicants outside these regions will not be contacted. Residential addresses will be verified prior to program admission via applicants' government issued photo ID.
Please Select
Please Select
100 Mile House
Abbotsford
Agassiz
Alert Bay
Anmore
Armstrong
Ashcroft
Barriere
Belcarra
Bella Bella
Bella Coola
Bowen Island
Burnaby
Burns Lake
Cache Creek
Campbell River
Canal Flats
Castlegar
Central Saanich
Chase
Chemainus
Chetwynd
Chilliwack
Clearwater
Clinton
Coldstream
Colwood
Comox
Coquitlam
Courtenay
Cranbrook
Creston
Cumberland
Daajing Giids
Dawson Creek
Delta
Duncan
Elkford
Enderby
Esquimalt
Fernie
Fort Nelson
Fort St James
Fort St John
Fraser Lake
Fruitvale
Gibsons
Gold River
Golden
Grand Forks
Granisle
Greenwood
Harrison Hot Springs
Hazelton
Highlands
Hope
Houston
Hudson's Hope
Invermere
Kamloops
Kaslo
Kelowna
Kent
Keremeos
Kimberley
Kitimat
Ladysmith
Lake Country
Lake Cowichan
Langford
Langley
Lantzville
Lillooet
Lions Bay
Logan Lake
Lumby
Lytton
Mackenzie
Maple Ridge
Masset
McBride
Merritt
Metchosin
Midway
Mission
Montrose
Nakusp
Nanaimo
Nelson
New Denver
New Hazelton
New Westminster
North Cowichan
North Saanich
North Vancouver
Northern Rockies
Oak Bay
Oliver
Osoyoos
Parksville
Peachland
Pemberton
Penticton
Pitt Meadows
Port Alberni
Port Alice
Port Clements
Port Coquitlam
Port Edward
Port Hardy
Port McNeill
Port Moody
Pouce Coupe
Powell River
Prince George
Prince Rupert
Princeton
Qualicum Beach
Quesnel
Radium Hot Springs
Revelstoke
Richmond
Rossland
Saanich
Saanichton
Salmo
Salmon Arm
Salt Spring Island
Sayward
Sechelt
Shawnigan Lake
Sicamous
Sidney
Silverton
Slocan
Smithers
Sooke
Spallumcheen
Sparwood
Squamish
Stewart
Summerland
Sun Peaks Mountain
Surrey
Tahsis
Taylor
Telkwa
Terrace
Tofino
Trail
Tumbler Ridge
Ucluelet
Valemount
Vancouver
Vanderhoof
Vernon
Victoria
View Royal
Warfield
Wells
West Kelowna
West Vancouver
Whistler
White Rock
Williams Lake
Zeballos
If your city is not listed here, please enter the closest one.
7
At the time of training, will you be at least 16 years old?* This field is required.
YESNO
8
Do you have a Social Insurance Number (SIN)?* This field is required.
YESNO
9
Have you accessed any other CWRG funded training projects this fiscal year? (April 1st, 2026 - current)* This field is required.
YESNO
10
Are you/will you be enrolled in any other federally or provincially funded training programs at the same time as this project?* This field is required.
YESNO
11
What is your employment status?* This field is required.Note: Full-time workers are now eligible to access CWRG funding.
Unemployed
Employed: Part-time [less than 30 hours/week]
Employed: Seasonally
Employed: Casually
Employed: Precariously [At risk of losing a job and in need of training for a new job]
Employed: Full-time, Permanent [30+ hrs/week & NOT precarious]
12
Are you a Canadian Citizen; or a Permanent Resident; or Protected Person entitled to work in Canada?* This field is required.
Canadian Citizen
Permanent Resident
Protected Person (& entitled to work in Canada)
None of the above
13
Please check the box to confirm your acceptance (1):* This field is required.
By submitting this form, I agree to have my submitted information shared with BC Care Providers Association's (BCCPA) contracted training partner. I understand that the training provider will contact me directly to initiate the admission process if my profile aligns with the intake criteria.
14
Please check the box to confirm your acceptance (2):* This field is required.
I acknowledge that by submitting this request, I am neither offered nor guaranteed admission to the program. This form does not serve as a waitlist. I understand that BCCPA and their training partners will only contact individuals selected for further screening.
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