BCCFA ADULT VOCATIONAL SERVICES INQUIRY FORM
Please select the program you are inquiring about:
THRIVE
Who is completing this inquiry?
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I am referring on behalf of someone else
I am referring myself
Coast Capital THRIVE Program
To be eligible for employment support with the Coast Capital THRIVE Program, participants must be between 19-29, have a disability or chronic health issue, and be currently enrolled in or recently graduated from post-secondary education.
I confirm that the person I am referring meets the eligibility criteria for the Coast Capital THRIVE Program
Yes
Coast Capital THRIVE Program
To be eligible for employment support with the Coast Capital THRIVE Program, participants must be between 19-29, have a disability or chronic health issue, and be currently enrolled in or recently graduated from post-secondary education.
I confirm I meet the eligibility criteria for the Coast Capital THRIVE Program
Yes
Referrer Information
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Referrer Last Name
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Client Information
First Name
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Date of Birth
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Female
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Level of education completed?
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Elementary
Secondary completed
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Post-secondary partially complete
Do you self-identify as a person with a disability or long-term health issue?
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If Yes, please specify: (Check all that apply)
Agility
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Additional Background Questions for THRIVE Inquiry
What would you like us to know about your disability/health issue and how it impacts you at work?
Reason for this inquiry: What possible assistance, support and accommodation solutions are you looking for? What would like to achieve through this program?
What is your biggest struggle when it comes to looking for employment? Where do you feel you could use the most support in your job search?
I hereby declare that the information provided is true and correct
Yes
The client is aware of and has provided consent for me to make referral on their behalf
Yes
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