Pre-Registration Form -

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Name and Contact Information

Name:

Phone:

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E-mail:

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Personal Information

Age:

About You:(Check all of the following that apply to you.)

I am unemployed
I am working 19 hours or less per week
I am on, or eligible for Employment Insurance (EI)
I have been on EI in the last 3 years
I have been on maternity leave within the last 5 years
I am attending school
I am legally allowed to work in Canada

What city is closest to you?:

Kelowna
Penticton