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

Note: Students must use Student Employment Application only

Personal information on this form is collected under section 31(c) of the Freedom of Information and Protection of Privacy Act R.S.P.E.I. 1988, c. F-15.01 as it relates directly to and is necessary for the administration of the PEI Employment Development Agency’s programs 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 PEI Employment Development Agency, 548 Main Street, PO Box 1180, Montague, 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:
Sports/Recreation
Tourism
Environment
Agriculture/Fisheries
Other
Information:
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
Date of Birth


Month: *
Day: *
Year: *
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:
Address:
Telephone:
Education


Education:
School/G.E.D
College
University
Grade:
Years Completed:
College Program:
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:
Are you currently employed:
Yes
No
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 Certificates:


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 Certificate (1):
Trade Certificate (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 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.
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