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Community Health Worker Training Program Application of Interest
Train on Gabriola, Work on Gabriola
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* Indicates required question
Email
*
Your email
First and last name
*
Your answer
What is your address?
*
Your answer
Phone number
*
Your answer
Do you have a current Food Safe certification?
*
Yes
No
Would you like to register for the Tuesday, July 9th Food Safe course at the Gabriola Fire Hall? Attendance is on a first come, first serve basis. PHC will contact you to confirm your registration.
*
Yes
No
Do you have a current standard First Aid certificate?
*
Yes
No
Have you successfully completed English 12?
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Yes
No
No and I would be interested in help obtaining my English 12 equivalency.
Other:
Are you a Canadian citizen?
*
Yes
No
Do you have a driver's licence?
*
Yes
No
Do you have a reliable vehicle?
*
Yes
No
Are you currently employed?
*
Yes
No
If so, how many hours per week are you employed?
Your answer
How long have you been employed at your current job?
Your answer
If you need to leave your job to attend this training, would you like to meet with a BC Works counsellor to determine your eligibility for wage replacement assistance?
Yes
No
Maybe
Clear selection
If you leave your current job to take this training and you were not eligible for government assistance, would you be interested in applying for a low interest loan to cover your living expenses? (Loans must be repaid in full immediately if you do not complete the training.)
Yes
No
Maybe
Clear selection
Will you be seeking funds to cover childcare expenses?
*
Yes
No
Maybe
Do you understand that it is the applicant’s responsibility to insure that all admission requirements have been met?
*
Yes, I understand.
No, I do not understand.
Required
Did you attend the information session on June 13th at the Gabriola Library?
*
Yes
No
Comments
Your answer
A copy of your responses will be emailed to the address you provided.
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