NENAS Client Registration v2

CLIENT FORMS

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CLIENT FORMS

Home
About
Services and Programs
Community Sponsorship Program
Calendar
- CONNECT
Community News
Contact

NENAS Client Registration

- Step 1 of 5

FOR NENAS OFFICE USE ONLY

For NENAS Office Use Only

CRF
EI Client

ARMS ID:

Funded Service

PPE
PPE/Safety Tickets
Trade
Post-secondary Education
Micro-credentials

Non- Funded Service

Career Exploration/Counselling
Resumé Writing
In-House Jobs Boards/Job Search

Client Information

Name *

First

Middle

Last

Social Insurance Number

Date of Birth

Cell Phone Number

Alternate Phone Number

Email *

Gender

Male
Female
Other

Residential Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Mailing Address (if different)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Marital Status

Married/Common Law
Single

How many children 18 years old or younger do you have residing with you?

Do you have a current valid driver's license?

If yes, Class of License

Aboriginal Ancestry

Status

First Nation Status
Non-Status
Inuit
Métis
Non-Aboriginal
Immigrant

Do you live

On-Reserve
Off-Reserve

Band Name (if applicable)

Band Registration Number

Education and Training

What High School Grade did you complete?

Year

Province

List any post-secondary education (Certificate/Diploma/Degrees)

Please list the safety tickets you have or that you require

EMPLOYMENT OR UNEMPLOYMENT DETAILS

Are you

Employed

If Employed, please indicate

Full-time
Part-time
Self-employed

Who is your Employer?

What is your Job TItle?

What is your hourly wage/annual salary?

Are you

Unemployed
Student

Are you currently receiving:

Have you received EI in the past 5 years?

Maternity EI

Have you received Maternity EI in the past 5 years?

WorkSafeBC Payments

Disability Payments

Income Assistance Payments

CLIENT DECLARATION

CONTENT PENDING

Signature

Please contact us if you have any questions or need any assistance completing your registration.

Phone

(250) 785-0887

Email

nenas@nenas.org

Treaty 8 Territory

In unity, we live and learn on Treaty 8 Territory, a traditional meeting ground, gathering place, and traveling route to the Sikanni, Slavey, Beaver (Dane-Zaa), Cree, and Saulteau whose footsteps have marked these lands for centuries.

About

NENAS has been developing and providing an extensive range of programs and services for over 30 years to our First Nations and Urban Communities in Northeast BC.

We provide a wide range of programs, training, and services that are all geared towards helping people gain employment and life skills. We offer employment assistance services, family and Elder programs, support childcare initiatives, and maintain partnerships for the benefit of our participants.

Partners

Contact

Hours:
Monday: 9:00 – 5:00
Tuesday:   9:00 – 5:00
Wednesday:   9:00 – 5:00
Thursday:   9:00 – 5:00
Friday: 9:00 – 5:00
Saturday / Sunday:   Closed

10328 – 101 Avenue
Fort St. John, BC V1J 2B5

Main office: 250.785.0887
Toll free: 1.855.785.0887
Email: nenas@nenas.org