Register

I would like to be contacted by YES within two (2) business days to book an appointment. Please note that a SIN is required to book an appointment.
—Please choose an option—YesNo - I will contact YES at a later date

How did you hear about us?
—Please choose an option—Apprenticeship ManitobaCAHRDCommunity AgencyEAS Service ProviderEmployability Assistance for People with DisabilitiesEmployerEmployment Manitoba PosterEmployment Partnership Service ProviderFamily/FriendFirst Nations OrganizationGovt Asst Refugee/Labour & ImmigrationHRSDC - Service Canada (Walk-in)InternetJob LinksManitoba StartMetis OrganizationNewspaper/AdProvincial AssistanceSchool/Transitional PlanningSelfTraining & Employment Services (TES)Training Institution

Contact Information

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Dependents

A dependent is an individual who lives in the same household as the participant and for whom they have caregiving responsibilities. The dependent may be a child (by birth, marriage, adoption or be a foster child) or an adult dependent (e.g. an adult offspring with a disability).

—Please choose an option—YesNoNot Declared

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About

Date of Birth

Gender Identity

Gender Pronoun

Marital Status
—Please choose an option—Married or EquivalentNot DeclaredSingle

Preferred Language
—Please choose an option—EnglishFrenchOther

Preferred Contact
—Please choose an option—PhoneEmailText

Indigenous Status
Status (On-Reserve)Status (Off-Reserve)Non-StatusMetisInuitNone

Residency Status
—Please choose an option—Canadian CitizenPermanent ResidentRefugee ClaimantStudent VisaWork Visa

If Permanent Resident or Refugee ONLY

Are you a member of a visual minority?
YesNoNot Declared

Do you have any disabilities that may impact employment? Disabilities can range from physical, mental/psychiatric, or learning/intellectual.
YesNo

Source of Income
—Please choose an option—EmployedSelf-EmployedProvincial Assistance (EIA)Employment Insurance (EI)NoneOther

If Employed / Self Employed - Complete the following: Company Name - Position Title - Hire Date - Hours Worked Per Week - Hourly Wage

Other

How long have you been looking for employment?
—Please choose an option—Less than 4 weeks1 - 6 Months7 - 12 Months13 - 24 MonthsMore than 24 months

Are you currently in CFS care?
—Please choose an option—YesNo

Have you ever been in CFS care?
—Please choose an option—YesNo

Highest Level of Education
1 Year Apprenticeship1 Year College/Vocational Education1 Year University Education2 Year Apprenticeship2 Year College/Vocational Education2 Year University Education3 Year Apprenticeship3 Year College/Vocational Education3 Year University Education4 Year ApprenticeshipBachelor's DegreeCollege/Vocational DiplomaDoctorateGEDGrade 10Grade 11Grade 12Grade 5Grade 6Grade 7Grade 8Grade 9Journeyperson CertificationMaster's DegreeNo Formal Education

Year Completed
—Please choose an option—200820092010201120122013201420152016201720182019202020212022202320242025

School/Institution

Did Youth Employment Services ever present at your school?
YesNo

Have you completed any of the Trainings or received Certificates of the following:
CPR/First Aid
Certified Food Handler
Mental Health First Aid
Non-Violent Crisis Intervention
WHMIS
Serving it Safe/It’s Good Business/Smart Choices
Forklift Certification
ASIST: Applied Suicide Intervention Skills Training
Driver’s License
Own Vehicle/Transportation
Other

As part of our funding agreement, we require the following Privacy Notice and Consent Form for Training and Employment Services to be signed. Please note Youth Employment Services is compliant with all FIPPA and PIPEDA legislation.

I agree to the Privacy Notice And Consent Form.

Client Signature

Current Date

I give my consent to subscribe to Youth Employment Services’ (Y.E.S. Manitoba) electronic mailing list to receive upcoming workshop information, training information, and other agency news. I also understand by consenting, I may unsubscribe at any time.