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Youth Employment Program
Program Starts: January 8, 2024
Address: 4460 Beresford St, Burnaby V5H 0B8
Contact us at 604-431-0400 (Blenn) / 236-858-4979 (Debby) or employment@burnabynh.ca / caseworker@burnabynh.ca
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* Indicates required question
First Name (as it appears on SIN card)
*
Your answer
Last Name (as it appears on SIN card)
*
Your answer
Social Insurance Number
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Address of Residence & Postal Code
*
Your answer
Phone Number
*
Your answer
Email
*
Your answer
Gender
*
Male
Female
Other
Prefer not to answer
Member of a Visible Minority
*
Yes
No
Prefer not to answer
Person with Disability
*
Yes
No
Prefer not to answer
Indigenous Group
*
Non status
Metis
Inuit
Registered no-reserve
Registered off-reserve
N/A
Residency Status
*
Canadian Citizen
Permanent Resident
Protected Person Entitled to work in Canada
Level of Education
*
Elementary
Secondary completed
Secondary in-complete
Post-secondary completed
Post-secondary in-complete
University Degree
Major of University Degree and Completion Year
Your answer
Are you currently working
*
Yes
No
Are you currently participating in another education or training program
*
Yes
No
How did you hear about us?
*
Community Organization
Facebook/Instagram
Family/Friend
Internet Search
Other
Consent
*
I consent to Burnaby Neighbourhood House sending me information about upcoming programs, events, volunteer opportunities, newsletters, program offerings, and other promotional type offerings. While you are a current Youth Employment Program client, you will receive informational emails necessary for your continuance in our programs.
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