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Lighthouse Project 2023-2026
Welcome! If you complete this form, it will provide the staff at the Lighthouse Project at Youth Employment Services YES with enough information to be able to contact you about the program.
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First Name
Your answer
Last Name
Your answer
Phone Number
Your answer
Can we leave confidential voicemails at that phone number?
YES
NO
Clear selection
Email Address
Your answer
The Lighthouse Project is available to clients that live in Ontario. Do you live within our catchment area?
*
Yes
No
What is your current address?
*
Your answer
Are you currently employed?
Yes
No
Other
Clear selection
How many hours have you worked within the last 52 weeks?
More than 665
Less than 665
Unsure
Not Applicable (was not working)
Clear selection
Are you currently in school?
Post-Secondary (college or university)
Secondary (High School)
No
Clear selection
Do you meet our eligibility criteria? 1) identify with a mental health issue, or feel stressed or anxious about finding employment and 2) legally entitled to work in Canada
Yes
No
Uncertain
Clear selection
How did you hear about the Lighthouse Project?
Social Media (Instagram, Facebook, LinkedIn, etc.)
YES Website
A Poster in the Community (e.g. at the library, a hospital, or community centre, etc.)
A friend or family member
YES Staff Member
Mental Health Support Worker
Other:
Clear selection
Do you identify with a disability?
Yes, Mental Health
Yes, but not Mental Health
Would Rather Not Say
No
Clear selection
Is there anything else you would like us to know about you?
Your answer
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