PLAN Practice Form

Ministry of Labour,
Training and Skills Development

Ontario Bridge Training
Program Participant
Registration

Participant Details

Last Name *

First Name *

Middle Initial

Preferred Name

I identify as: *

LGBTQ+

Yes

Prefer not to answer

Race Category - Select All that Apply

Date of Birth *

Date Arrived in Canada (if born outside Canada)

Place of Birth (Country)

Social Insurance Number

The collection of Social Insurance Numbers (SIN) is a requirement for individuals participating in programs funded by the Ontario Government including Employment Ontario Service Centres. This information confirms that you are legally entitled to work in Canada.

Status in Canada *

Canadian Citizen

Permanent Resident

Naturalized Canadian Citizen

Protected Persons

Refugee Claimant

Prefer not to say

What is your first language?

Preferred Language *

English

French

Immigrated to Canada? *

Yes

Not Applicable

Prefer not to disclose

Immigration Class Category *

What is currently your main source of income? What is currently your main source of income?

Please complete if you wish to self-identify as a member of a designated group(s). Your response to this question is entirely voluntary and will not affect your eligibility. This information will be used by the Governments of Ontario and Canada for policy analysis and statistical purposes related to employment programs and services. (You may select more than one (1) option:)

Participant Address and Contact Information

Unit Number

Street Number *

Street Name *

PO Box

City/Town *

Province *

Postal Code *

Primary Phone Number

Home

Mobile

Other

Telephone Number

Alternate Phone Number

Home

Mobile

Other

Telephone Number

Email Address

Preferred Communication

Phone

Hard Copy

Education

Internationally Trained Professional

Yes

Education Type

Institution of Highest Level of Education

Program Description

Start Date (dd/mm/yyyy)

End Date (dd/mm/yyyy)

Type

Full-Time

Part-Time

Country of Institution

Additional Education

Some Apprenticeship

Some College

Some University

Institution of Additional Education

Program Description

Start Date (dd/mm/yyyy)

End Date (dd/mm/yyyy)

Type

Full-Time

Part-Time

Country of Institution

Employment

List your work experience, including volunteer work. Start with the most recent job/volunteer activity.

Work Experience 1 (most recent)

Employment Type

Name of Employer

Job Title/Duties *

Employment Start Date (dd/mm/yyyy)

Employment End Date (dd/mm/yyyy)

Country of Employment

Salary Range

Employment Hours Per Week

Reason for Leaving

Work Experience 2

Employment Type

Name of Employer

Job Title/Duties

Employment Start Date (dd/mm/yyyy)

Employment End Date (dd/mm/yyyy)

Country of Employment

Salary Range

Employment Hours Per Week

Reason for Leaving

Work Experience 3

Employment Type

Name of Employer

Job Title/Duties

Employment Start Date (dd/mm/yyyy)

Employment End Date (dd/mm/yyyy)

Country of Employment

Salary Range

Employment Hours Per Week

Reason for Leaving

Client Consent to Collect, Use and Disclose Personal Information

1. JVS Toronto Consent
I understand that JVS Toronto will collect, use, store, and disclose my personal information only as necessary to deliver employment-related services, in accordance with applicable privacy laws. This may include personal details such as my age, name, contact information, employment history, and other relevant information. JVS Toronto will not disclose my personal information to third parties without my consent unless legally required to do so. My information will be collected fairly, stored securely, and used only for the purposes identified by JVS Toronto. I also acknowledge that JVS Toronto maintains a safe, respectful, and inclusive environment, and I agree to follow its rules and regulations. Additionally, I understand I can choose whether or not to receive electronic communications from JVS Toronto about unrelated announcements, events, or fundraising activities, and I may withdraw this consent at any time by contacting my JVS Toronto representative.

2. Ministry of Labour, Training and Skills Development Consent
I understand that the services I receive through JVS Toronto are funded by the Ministry of Labour, Training and Skills Development (the Ministry), and may also be funded in part by the Government of Canada. I consent to the collection, use, and disclosure of my personal information—including information from Employment Insurance (EI) records, my employer, or from the Ontario Disability Support Program (ODSP) or Ontario Works (OW)—for the purposes of assessing my eligibility, delivering services, evaluating service effectiveness, and fulfilling the Ministry’s reporting, auditing, policy development, and public awareness responsibilities under applicable legislation. This includes the collection of my Social Insurance Number (SIN) where required under the Employment Insurance Act and associated agreements. I understand that my information may be shared with the Ministry of Children, Community and Social Services (MCCSS) if I am an ODSP or OW client. For more information, I may contact the Employment Ontario Call Centre at 1-800-387-5656 or TTY: 1-866-533-6339.

3. Approved Bridging Program Provider - an educational institution (college, university)
I consent to JVS Toronto sharing only information that is necessary for the delivery, administration, and evaluation of the bridging program with the Approved Bridging Program Provider - an educational institution (college, university), where applicable. This includes information directly related to my participation, progress, and outcomes in the program. Only information pertinent to program delivery will be shared, in accordance with Canadian privacy laws and principles of data minimization.

Signatures

By signing below, I give consent to JVS Toronto to collect, use, and disclose my personal information for the purposes set out above.

Participant's Signature

Clear

What is your status in Canada?

What is your employment status?

Because you are employed full-time, you are not eligible for this service.

Are you an Ontario resident?

Yes

What is your status in Canada?

Questions or Comments:

PEAC is only open to residents of Ontario.

Citizenship Status:

Permanent Resident

Convention Refugee

CUAET holders

OtherOther

Do you currently live in Ontario?

Yes

Please select your Canadian status

Thank you for your interest in JVS Toronto services. Since you are located outside Ontario, you are not eligible for this program. However, you are welcome to attend our free workshops and events. Review our Workshop and Events Calendar here.

Thank you for your interest in JVS Toronto services. Due to your Citizenship Status you are not eligible for this program. However, you are welcome to attend our free workshops and events. Review our Workshop and Events Calendar here.

Questions or Comments

Are you a Permanent Resident or Convention Refugee?

Yes

Are you between 15 and 18 years old? *

Yes

I am the parent of a child between the ages of 15 and 18

Questions or Comments

Are you currently employed? *

Yes

Are you currently in enrolled in school? *

Yes

Where do you live? Where do you live?

Questions or Comments:

So you currently live in Ontario?

Yes

Please select your Immigration Status

Are you currently employed? *

Yes

Are you currently in enrolled in school? *

Yes

Do you currently live in Ontario? *

Yes

Please select your Immigration Status

Questions or Comments:

Are you currently employed? *

Yes

Are you currently enrolled in school? *

Yes

Do you currently live in Ontario? *

Yes

Please select your Immigration Status

Questions or Comments:

Do you currently live in Ontario?

Yes

Please select your Immigration Status

Are you a Permanent Resident or Convention Refugee?

Yes

Are you between 15 and 18 years old? *

Yes

I am the parent of a child between the ages of 15 and 18

Questions or Comments

Do you currently live in Onatrio?

Yes

Please select your Immigration Status

Do you currently live in Ontario?

Yes

Please select your Immigration Status

Questions or Comments

What kind of program would you like to attend?

Online

In-Person

Do you currently live in Ontario? *

Yes

Please select your Immigration Status

Questions or Comments

Ministry of Labour,Training and Skills Development

Ontario Bridge TrainingProgram ParticipantRegistration

Participant Details

Participant Address and Contact Information

Education

Employment

Work Experience 1 (most recent)

Work Experience 2

Work Experience 3

Client Consent to Collect, Use and Disclose Personal Information

Signatures

Ministry of Labour,
Training and Skills Development

Ontario Bridge Training
Program Participant
Registration