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Employment Development Agency & PEI Government Seasonal Jobs Registry Student Employment Application


Personal information on this form is collected under section 31(c) of the Freedom of Information and Protection of Privacy A ct R .S .P.E.I. 1988, c. F-1 5.01 as it relate s directly to an d is necessary for the administration of the PEI Employment Development Agency’s program s and will be used for determining program eligibility and maintaining program data for statistical purposes. If you have any questions about this collection of personal information, you may contact the Director of the PEI Employment Development Agency, 548 Main Street, PO Box 1180, Montague, PE, C0A 1R0, Telephone (902) 838-0910. PE, C0A 1R0, Telephone (902) 838-0910.

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

Preferred program(s), type of work or career goal(s)


Career Goals - (Check (√) all that apply):
Sports Recreation
Tourism
Environment
Agriculture Fisheries
Other information:
The PEI Human Rights Commission has approved these questions for statistical use and to determine eligibility for targeted employment programs.


Are you a resident of PEI ?: *
(Applicants 16-29 years old who are attending school off island, please choose “Yes”)
Yes
No
Personal Information


Last Name: *
First Name: *
Initial:
Civic Address: *
Rural Route/PO Box: *
Postal Code: *
Community Name: *
Province: *
Telephone: *
Telephone (other):
Email Address:
Gender: *
Male
Female
Month of Birth (99): *
Day of Birth (99): *
Year of Birth (9999): *
Your voluntary response to the following questions will assist us in determining our diversity and equity goals.


Are you:
An aboriginal Person?
Are you:
A person with a disability?
Please Specify:
Are you:
A member of a Visible Minority?
Please Specify:
Emergency Contact:
Name, Address and Telephone numbers, email address
(Education) - Are you currently enrolled in full time studies?


Are you currently enrolled in full time studies?: *
Yes
No
Will you be returning to school full time in the current year?: *
Yes
No
Undecided
State reason ?:
Highest education currently enrolled and completed by Summer? Check all that apply:
School
College
University
BA
MA
PHD
Diploma
School/G.E.D
High School Grade Completed:
College Years Completed:
College Program:
University Years Completed:
Faculty:
Major(s):
Skills/Work Experience/Volunteer Work Beginning with your most recent employment, list employer, type of work and dates worked:
(You may attach your resume)
Attach Resume:
(Optional)
Languages Spoken: *
English
French
Other (Specify below)
Other:
Clerical and Computer Skills, Check all that apply:
Computer Programmer
Computer Technician
Data Entry
Word Processing
Internet/Email
Spreadsheet
Web Design
Admin Support
Bookkeeping
Clerk/Cashier
Licensing, Trades and Course Certificate Check all that apply:
First Aid
Lifeguard
WHMIS
CPR
Pesticides
Security
Chainsaw
Flagging
Valid Driver's License?:
Yes
No
Class?:
Heavy Equipment Operator?:
Yes
No
Class?:
Trade Certificates (1)?:
Trade Certificates (2)?:
Access to Transportation:
Yes
No
Other Related Skills Check all that apply:
Health/Seniors Support Worker
Responsible Beverage Server
Forestry Worker
Environment Support
Trail Maintenance
Golf Course Worker
Highway Maintenance
Janitorial Worker
Super Host Program
Tourism Support
Comments:
Declaration: *
I certify that the foregoing statements made by me are true in substance.




I authorize the PE I Employment Development Agency and the PE I Department of Fisheries, Aquaculture and Rural Development to verify the above information, to obtain or release information pertaining to m y suitability for employment and/or toobtain or release confidential information on employment insurance eligibility to be use d only for the purpose o f providing employment opportunities.

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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.

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