TechWORKS - Application Form In order to determine your eligibility for the TechWORKS, please answer the following questions (you may be asked to provide supporting documentation):Name:* Phone Number:*Email* To qualify for TechWORKS for Young Adults you must meet: 18 – 24 years of age Living on Vancouver Island Unemployed or precariously employed 1) I am between the ages of 17 and 29, inclusive:* Yes No If yes: How old are you?*Please enter a number from 18 to 24.2) I am unemployed.* “Unemployed means you are available for work but do not have work and includes those: • who are on temporary layoff with an expectation of recall • who have actively looked for work in the past four weeks or • who have a new job to start within four weeks.” Yes No 3) If employed, I am working less than 30 hours a week, on average.* Yes No Not Applicable / Unemployed If you are working, do not quit your job as this may affect your eligibility for the program.4) Are you receiving Employment Insurance?* NOTE: If you have worked and may have enough hours to qualify, you will need to apply. You are to contact Service Canada and disclose your intended purpose to participate in the TechWORKS program including providing Service Canada with the length of the training. It is up to you to manage your relationship with Service Canada and any impact your participation in the program may have on your active claim. Yes No 5) Are you on Income Assistance, or classified as Person with Disability?* Yes No 6) I am legally entitled to work in Canada.* Yes No 7) Are you living on Vancouver Island?* Yes No Please provide your address:* Street Address City Postal Code 8) I am currently a full-time student or enrolled in high school.* Yes No 9) I am currently participating in another government-funded program.* Yes No If yes, please enter name of program:* Have you applied to any other ETHOS programs?* Yes No If yes, please enter name of program:* Do you have access to a computer?* Yes No Do you have access to a webcam?* Yes No What is your preferred contact method?* E-mail Phone 10) How did you learn about the TechWORKS PROGRAM?