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Special Projects Program Application for Employers

The Special Projects Program is designed to assist in the creation of innovative employment and training opportunities for employment disadvantaged Islanders.

Eligible employers are non-profit organizations in PEI and municipal governments incorporated in PEI, including their sponsored agencies.

Eligible employees are persons at least 30 years of age who have or are about to exhaust their Employment Insurance benefits.

Please read the guidelines before completing this application.

Fields marked with a red star (*) are mandatory.

Part 1 - Applicant Information


Organization Name: *
Address: *
Community:
Postal Code:
X9X 9X9
Telephone:
(555) 555-5555
Fax:
(555) 555-5555
Email:
Contact Information


Primary Contact Name: *
Working Title: *
Telephone: *
(555) 555-5555
Alternate Contact Name:
Working Title:
Telephone:
(555) 555-5555
Part II Project Description


Project Name: *
State the name of your project? (40 chars max)
Objectives or Results


State the objective(s) or anticipated results of your proposal.
Objectives: *
Activities


Outline the activities planned to meet the objective(s).
Activities: *
New Initiative


Is your project a new initiative? If not, explain why the project is being revived.
Project Information: *
Project Funding


Was your project proposal previously funded through a government program? If so, indicate the name of the program and attach a project summary of activities carried out.
Name of Program:
Project Summary Attachment:
Long Term Benefits


What long term benefits will be derived from your proposed project?
Benefits: *
When will your project operate?


Payroll usually operates from Sunday to Saturday. Normally, you would start on Monday and finish on Friday. Use Date Format (MM/DD/YY) exactly as shown.
Start Date: *
(MM/DD/YY)
End Date: *
(MM/DD/YY)
Required Positions


Supervisory Positions


Identify supervisor's position(s) by position title, start and completion dates and duration. Project supervisors receive (PEI Minimum Hourly Wage X 5.5% X 4.0% Vacation Pay) for 40 hours per week. Use Date Format exactly as shown.

If you are not hiring a supervisor, go directly to the Staff Positions section.

Supervisory Position(s)


Working Title:
Start Date:
(MM/DD/YY)
Finish Date:
(MM/DD/YY)
Wage Rate:
Number of Weeks:


Requirements:
State the preferred education/skill/work experience for this position.
Positions


Identify the required staff position(s) by position title, start and completion dates and duration. Each approved position will be funded at the (PEI Minimum Hourly Wage X 4.0% Vacation Pay) for 40 hours per week.Use Date Format exactly as shown.
Position Title 1


If you require more employees, please attach a file outlining your requirements.
Working Title:
Start Date:
(MM/DD/YY)
Finish Date:
(MM/DD/YY)
Wage Rate:
Number of Weeks:
Requirements:
State the preferred education/skill/work experience for the position.
Position Title 2


Working Title:
Start Date:
(MM/DD/YY)
Finish Date:
(MM/DD/YY)
Number of Weeks:
Requirements:
State the preferred education/skill/work experience for this position.
Position Title 3


Working Title:
Start Date:
(MM/DD/YY)
Finish Date:
(MM/DD/YY)
Number of Weeks:
Requirements:
State the preferred education/skill/work experience for this position.
Position Title 4


Working Title:
Start Date:
(MM/DD/YY)
Finish Date:
(MM/DD/YY)
Number of Weeks:
Requirements:
State the preferred education/skill/work experience for this position.
Position Title 5


Working Title:
Start Date:
(MM/DD/YY)
Finish Date:
(MM/DD/YY)
Number of Weeks:
Requirements:
State the preferred education/skill/work experience for this position.
Declaration


In submitting this information I acknowledge that I have read and fully understand the conditions of application under the Employment Development Agency program. I certify that the statements contained in this application and any attachments are to the best of my knowledge true and correct.

Do you want a copy of the form?


Please send me a simple text-only version of the information I submitted.
Please send me an Acrobat version of the form, with the information I've entered above filled in, that I can print and save.
Please send me both the text-only version and the PDF.
Important Note: Email is not, by its very nature, a secure medium; if you choose to have your form emailed to you, the information you entered will be transmitted over the public Internet to your email box.

Email to address:

Submit the Form


* There are several contact persons for this form. Please select the contact person from the list below to whom your form should be directed.

Employment Development Agency (Group Login) (Employment Development Agency )
Amanda O'Brien (Employment Development Agency )
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When you click here, the information you've entered above will be sent to the public servant responsible for receiving and processing this form. If you've opted to receive an Acrobat version of the form by email, you will receive this file shortly.
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