Intake Application Form

Intake Application Form 2019


Date of Birth

e.g. 717 818 919

Mailing Address

Email Address

Phone Numbers

e.g. (604)111-1111
e.g. (604)111-1111
Enter the number of hours
Enter the wage per hour
Enter the number of years, if not applicable leave it blank.
Enter the number of months, if not applicable leave it blank.
Participant Consent
As part of your participation in the Self-Employment Training For Young Adults (SET) program, personal information will be collected from you including but not limited to your name, social insurance number, contact, and demographic information. Following completion of the training, all Participants are required to provide feedback about the program, the outcomes of the training, and whether the training met your employment needs ("Surveys"). You may also be asked if you wish to, or may volunteer to, provide a testimonial regarding your program experience ("Testimonial").
Personal Information Collection Notice
All personal information in the Participant Intake form, the Surveys, any Testimonial and other information related to your participation in the program (“Personal Information”) is collected pursuant to sections 26(c), 26(e), and 27(1)(a)(i) of the Freedom of Information and Protection of Privacy Act.

This information will be used for administrative, evaluation, program development, and /or research purposes, including to determine your eligibility for participation in the program. This information may also be disclosed to the BC Ministry of Education, the BC Ministry of Social Development and Poverty Reduction, the BC Ministry of Indigenous Relations and Reconciliation and/or the BC Ministry of Jobs, Trade and Technology for administrative, evaluation, program development and/or research purposes, and will be provided to the Government of Canada (“Canada”) to meet reporting requirements about programs funded by Canada through the Canada-British Columbia Workforce Development Agreement.

If a Testimonial is provided, the Testimonial may be used and disclosed to publicly promote the program.

Consent and Agreement
Effective as of the date set out below, and in consideration of the opportunity for me to participate in Self-Employment Training for Young Adults (SET) Program training, I:
• Certify that all of the information that I have provided is accurate and complete;
• Certify that I understand that my agreement to provide this information and complete the surveys is a condition of participation in the program;
• Consent to the collection (including indirect collection), disclosure, and use of my Personal Information by the Province of British Columbia and the Government of Canada for the purposes described above;
• Consent to my Personal Information being used to contact me to conduct the Surveys and to request a Testimonial.

If you have any questions about the collection and use of this information, please contact the Director, Employment and Training Programs, by telephone at 250-508-5671, or by mail at:

Director, Employment and Training Programs
Workforce Innovation and Division Responsible for Skills Training
Ministry of Advanced Education, Skills and Training
PO Box 9189 Stn Prov Govt Victoria BC V8W 9E6

I, the undersigned, hereby accept and agree to the above terms and conditions.

3. Privacy Agreement

SET is committed to protecting personal information by employing responsible information handling practices and respecting privacy information laws. We collect, use and disclose personal information in order to better meet your service needs, to ensure the safety of our participants, for statistical purposes, to satisfy government and regulatory obligations, and to inform you about S.U.C.C.E.S.S. programs and services.

By signing below, I am indicating that I understand that the SET program will collect, use and disclose my personal information contained within this Application for the SET program for the above‐noted purposes only, and I consent to the release of my personal information by the SET program to S.U.C.C.E.S.S. and the Government of BC which funds the SET program.

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“Indigenous” refers to persons or communities within present day Canada that include First Nations. Inuit and Métis.

“Casual Employment” means employment for a determinate period where it is known that the employment will not be continuous and will have an end date, whether or not the specific end date is known at the time of employment.

“EI claimant” means a person who is an active Employment Insurance (EI) claimant (i.e. receives employment insurance benefits) or former claimant (who has had an EI claim in the last 36 months, or for whom a claim for maternity or parental benefits has been established within 60 preceding months)

“Employed” means an individual who is receiving, or being entitled to receive, wages for work performed for an employer and being subject to regular employment deductions, or being self-employed. An individual who is working for no wages (i.e. volunteering) is not considered employed.

“First Nations” Officially called “Indians” in the Indian Act, this term refers to the indigenous peoples of North America located in what is now Canada, and their descendants, who are not Inuit or Métis.

“High School” means persons who have completed a high school diploma or equivalent (e.g. General Equivalency Diploma).

“Immigrant” means a person who is foreign born and has been permitted by immigration authorities to live in Canada permanently.

“In school or training” means a person who is in school or training and not currently employed.

“Inuit” The Inuit are the Aboriginal inhabitants of the North American Arctic.

“Less than High School” means a person not recognized as having completed a high school diploma or recognized equivalent and who does not have a diploma or certificate recognized in the BC labour market.

“Métis” means a person who self-identifies as Métis, is of historic Métis Nation ancestry, and is accepted by the Métis Nation. Métis people identify themselves, and are recognized, as distinct from First Nations (Indian), Inuit or European descendants.

“Non-EI claimant” means a person who is not currently eligible for EI benefits and who is not a former claimant.

“Non-university certificate or diploma such as a trades certificate” means a person who has a non-university certificate or diploma from a community college, school of nursing, etc. or a trades certificate or diploma from a vocational or apprenticeship training school.

“Not in the labour force” means those persons not in the labour force who are unwilling or unable; that is, they are neither employed nor unemployed. This also includes discouraged workers, who want to work but are not currently looking for work because they believe no suitable work is available.

“Permanent Employment” means when a job is expected to last as long as the employee wants the job, and as long as business conditions permit.

”Person with a Disability” means an individual who self-identifies as having a physical, cognitive/mental, sensory, or developmental disability which results in limitations executing tasks or actions that relate to employment.

“Personal Information” means recorded information about an identifiable individual other than contact information, as defined in the Freedom of Information and Protection of Privacy Act (British Columbia) (“FOIPPA”).

“Seasonal Employment” means employment for a determinate period, where it is known that the employment will not be continuous and will have an end date, whether or not the specific end date is known at the time of employment.

“Self Employed” means persons who are working owners of an incorporated or unincorporated business, farm, or professional practice, with or without paid help. The “un-incorporated” group includes self employed workers who do not own a business (such as babysitters and newspaper carriers). Self employed workers include unpaid family workers, i.e. persons who work without pay, on a farm or in a business or professional practice owned and operated by another family member living in the same dwelling.

“Some Post Secondary Education” means a person who had some post secondary education (i.e. post secondary program not complete).

“Temporary Employment” means a job that has a predetermined end date or will end as soon as a specific project is completed.

“Unemployed” means an individual who is not employed.

“University” means a person who has completed university and holds a bachelor’s degree, Master’s degree or PhD.

“Visible Minority” The Employment Equity Act defines visible minorities as “persons other than Aboriginal peoples, who are non-Caucasian in race or non-white in colour”. The visible minority population consists mainly of the following groups: Chinese, South Asian, Black, Arab, West Asian, Filipino, Southeast Asian, Latin American, Japanese and Korean.