Youth: H.I.R.E. (Youth Help in Reaching Employment): Registration

Please complete the form to submit an application for the Youth HIRE- Youth Employment Program. Applicants MUST be between ages 15-30 to be considered for the program. Questions labeled (Required) are mandatory to fill in. If you are not sure how to answer, please put “I don’t know” or “unsure” and it can be discussed later. Questions not labeled “Required” are optional. Program Staff will connect with you to discuss your application status soon.

Step 1 of 2

Legal Name(Required)
First Last
Preferred First Name (if applicable)
Date of Birth(Required)
Month
Day
Year

Month/Date/Year
Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Closest Major Street Intersection
Email(Required)
Cell Phone Number (###) ###-####(Required)
Home Phone Number (if applicable) (###) ###-####
Are you over the age of 18?(Required)
If you are under the age of 18, you must provide the contact information for a Parent or Guardian
Parent or Guardian Name
First Last
Parent or Guardian Email

*If under 18
Parent or Guardian Phone Number (###) ###-#### *If under 18
Emergency Contact Name(Required)
First Last
Emergency Contact Phone Number (###) ###-####(Required)
Residency Status(Required)
Are you legally permitted to work in Canada?(Required)
Level of Education(Please check the box that best describes your current situation)(Required)
- Some Elementary School
- Elementary School complete
- Some High School
- High School Diploma complete
- Some College
- College Diploma complete
- Some Univeristy
- University Degree complete
Mode of Transportation(Public Transit or car)
What types of jobs are you interested in?(Required)