Fall 2025 Workplace Education Service Registration Intake Form
Please complete this registration form so that you are able to receive your final certificate. Please fill this form out for each course you are registering for.
Sign in to Google to save your progress. Learn more
Which course are you registering for?
Clear selection
Last Name *
First Name *
Middle Initial
Birth Date (dd/mm/yyyy) *
Home Phone
Mobile Phone *
Email Address *
Mailing Address (Street Address, City, Postal Code) *
Civic Address (if different than Mailing Address)
Gender *
Designated Group - Indigenous Identity *
Designated Group - Immigrant *
Designated Group - Immigration Year
Designated Group - Person with Disabilities *
Designated Group - African Nova Scotian *
Designated Group - Francophone/Acadian
 *
Designated Group - Youth
 *
Designated Group - Visible Minority *
Pre-Intervention - Education Level (Choose One) *
Immediate Outcome: Employment Status (Choose One) *
Participant Employer: Business Sector (NAICS) *
Enter the North American Industry Classification System (NAICS) sector code for the sector of business you are employed with. 
Participant's Employer Name *
Enter the name of your employer (please spell out all words, do not use acronyms or abbreviations unless part of the company's legal name)
Submit
Clear form
Never submit passwords through Google Forms.
GoogleForms
This form was created inside of Megan's Workspace.