Intake Form

Please complete the details below to fill out the Intake Form.

eg. Box 69, Russell, MB R0J 1W0
eg. 2002
Year Only

An Employment Officer will contact you by phone/email to arrange an appointment time. Please check your junk/spam email folder as well incase our communication email ends up in there.

Alternatively, you can fill out the PDF below* and email it to

* Don’t forget to save the PDF before attaching it to your email or it will send as a blank form