Back To Teen Employment Program TEEN EMPLOYMENT PROGRAM REGISTRATION FORM Which type of session(s) are you applying for?*One on One Employment CounsellingCertificationsWorkshopsVolunteer Opportunities APPLICANT INFORMATION First Name* Last Name* Preferred Name Birth Date* Grade* Gender*—Please choose an option—BoyGirlNon-BinaryPrefer not to say Country of Origin* Date of Arrival in Canada* Address* Email * Phone Number* What is the best way to contact you?—Please choose an option—PhoneEmailRegular Mail Are You a *—Please choose an option—Permanent ResidentRefugeeOther Permanent Resident ID No. (UCI)* What school do you attend?* SECOND APPLICANT INFORMATION(IF APPLICABLE) First Name Last Name Preferred Name Birth Date Grade Gender—Please choose an option—BoyGirlNon-BinaryPrefer not to say Country of Origin Date of Arrival in Canada Are You a —Please choose an option—Permanent ResidentRefugeeOther Permanent Resident ID No. (UCI) What school do you attend? Parent/Guardian Information First Name* Last Name* Relationship to Child—Please choose an option—FatherMotherOther Address* Email * Phone Number* What is the best way to contact you?—Please choose an option—PhoneEmailRegular Mail Would the child need transportation?—Please choose an option—YesNo Parent/Guardian/Applicant Consent Select which applies to you:*I consent to the above child (or children) to participate in the Teen Employment Program (TEP) through the Saskatchewan Intercultural Association. I understand that the result of my child’s participation of the TEP program could lead to employment. I consent to the sharing of my child’s information with SIA program funders, and I understand that my child’s information may be shared with any authorized third parties for registration purposes, and that all information gathered will be kept confidential.I am 18 years old or older and I consent to participate in the Teen Employment Program (TEP) through the Saskatchewan Intercultural Association. I understand that the result of my participation of the TEP program could lead to employment. I consent to the sharing of my information with SIA program funders, and I understand that my information may be shared with any authorized third parties for registration purposes, and that all information gathered will be kept confidential Date* Parent/ Guardian/ Applicant Signature * Information Release Waiver: Consent to sharing personal information within SIA I consent to the Saskatchewan Intercultural Association to obtain, use, and release my personal information to any person or agency as may be necessary to support my learning and/or establish eligibility for my participation within other Saskatchewan Intercultural Association programs. YesNo Media Release Waiver: Consent to collect, use, and release pictures or comments I give consent to the Saskatchewan Intercultural Association (SIA) to use photographs taken of myself and to use my recorded comments in the Saskatchewan Intercultural Association's newsletter, on the agency's website and Facebook page, and in other promotional materials such as PowerPoint presentations, brochures, and displays. These photographs and comments will be for the sole use of the Saskatchewan Intercultural Association and will not appear with your full name unless requested. YesNo Email Release Waiver: Consent to electronic communications I give consent to the Saskatchewan Intercultural Association to use my email address to contact me about SIA-related programs, services, and events. Examples of communications would be program information, registration deadlines, upcoming events and classes, and SIA news. I understand that I can opt-out and unsubscribe at any time. YesNo Subscribe to receive email communications from SIA about programs, events and announcements YesNo Δ
