PCRS Baristas Training Program - Referral/Application Form

The Baristas Training Program is a youth employment service that supports Vancouver and Surrey's at-risk youth to achieve employment

Eligibility Requirements:

16-30 years old
Legally able to work in Canada
Must live in the lower mainland of Vancouver
Unemployed or precariously employed
Have not participated in another program funded by Access BladeRunners
Able to attend each class in person
There is a training allowance available

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Form Type

Program Code

Participant Information

Preferred Name

First Name

Last Name

Legal Name

First Name

Middle Name

Last Name

Contact Information

Primary Phone Number

Alternate Phone Number

Email Address

Home Address

Street 1

Street 2

City

Province

Postal Code

Alternate Address

Street 1

Street 2

City

Province

Postal Code

Basic Information

Date of Birth

Pronoun(s)

Social Insurance Number

Gender

Ethnicity

What language do you need support with?

Emergency Contact

Emergency Contact Name

Emergency Contact Relationship:

Emergency Contact Number

Emergency Contact Email

Education

Name Of School

Level Completed

Special Needs

Any Special Needs/Preferences That We Should Know About?

Any Health Issues/Conditions/Allergies, Past Or Present That We Should BE Aware Of?

Are There Any Diagnosed Learning Disabilities?

YESNoNot Sure

If yes, please specify

Previous Employment/Volunteer Experience

Are you legally Entitled to Work in Canada?

YESNO

Name Of Last Employer

Start Date

End Date

Reason For Leaving

Additional Information and Documents

How Did You Hear About The Baristas Training Program?

Resume

Cover Letter