APPLICATION for ABORIGINAL STUDENT JOB SHADOW PROGRAM Page 1 ABORIGINAL STUDENT JOB SHADOW PROGRAM (G.P.) Application Package Presented by the Indigenous Employment Coalition APPLICATION for ABORIGINAL STUDENT JOB SHADOW PROGRAM Page 2 Please read the Student Information Package prior to applying for this program. Submit your application directly to: Karen Scribner Program Coordinator, CAREERS: The Next Generation c/o Continuing Education Department, Office M 105, GPRC Fax: 780-539-2791 Email: kscribner@nextgen.org Applications must be received no later than May 29, 2015. Due to the anticipated volume of applications, only students selected for interviews will be contacted. Thank you for your interest in the Aboriginal Job Shadow Program. NAME: ________________________________ GENDER (please check): ADDRESS: Male ___ Female ___ ___________________________________________________________________________ HOME PHONE: _____________________________ CELL PHONE: _____________________________ Email Address: ___________________________________________________________________________ DATE OF BIRTH: ______________________________ Students in this program must be 15 to 17 years of age SIN # (or date you applied for a SIN): ____________________________ Required for pay during the program Alberta Student Number ______________________________________ Available on report card or from school Have you previously applied to this program? Yes ___ No ___ Do you have a Class 7 (Learners) License? Yes ___ No ___ Are you? (Please check only one): ___ First Nations ___ Metis ___ Inuit ___ Other Aboriginal Indicate Band ___________________________________________________ Specify __________________________________________________ Are you currently living on a reserve? Yes ___ No ___ If yes, name of Reserve _________________ Are you currently attending school? Name of School _______________________ Yes ___ No ___ Current Grade Enrolled or Last Grade Completed ______________ APPLICATION for ABORIGINAL STUDENT JOB SHADOW PROGRAM Page 3 Please ensure all information is provided. This information will assist in determining your suitability for the program. The information will be kept confidential and destroyed at the end of the program. Please note: this program is for students, and is not intended for people who are already working full-time. Have you taken the Work Experience Pre-Requisite Course? (HCS 3000 — Workplace Safety Systems) Yes ___ No ___ Have you taken any other career related training? Yes ___ No ___ If yes, what did you take? ___________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ We get a lot of applications for this program, so it is very important that you answer the next questions in great detail. Students are chosen for an interview based on how much detail and information you provide in your answers. If you require more room to answer the questions, please feel free to write on the back of the pages. What employment or volunteer experiences have you had (part-time or full-time)? ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ Why are you interested in participating in this program? ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ APPLICATION for ABORIGINAL STUDENT JOB SHADOW PROGRAM Page 4 Why are you interested in participating in this program? ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Please indicate why you would be a good candidate for this program. ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Please give a short description of your personal and future goals. What do you want to do when finished school? ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Do you have any special needs that we need to accommodate during the program? (For example: medical conditions, medications taken, allergies, etc.) ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ APPLICATION for ABORIGINAL STUDENT JOB SHADOW PROGRAM Page 5 IMPORTANT INFORMATION The program runs from July 5 to August 14. You are expected live at the GPRC dorms from Monday to Friday every week, and go home on the weekends. Even if you live in Grande Prairie you must stay in the dorms during the weekdays for the duration of the program. As students are under the age of 18, no student may use or possess cigarettes, tobacco, tobacco products, e-cigarettes, alcohol or illegal drugs at any time! There is a $400 per week training allowance provided to students accepted into the program, a $400 completion bonus for students who complete the 6 week program, and CEU credits may go toward high school graduation credits for participation in the program. Please see the Student Information Package for descriptions of positions available and other important information about the program. If you or your parents have any questions about the program, please contact: Karen Scribner Program Coordinator, CAREERS: The Next Generation c/o Continuing Education Department Office M 105, GPRC Phone: 780-539-2911 Email: kscribner@nextgen.org APPLICATION DEADLINE = May 29, 2015 WORKPLACE CHOICES Please read the Student Information Package and indicate which Job Shadow Positions you are most interested in. Please note: some employers rotate you through several positions. First Choice: _______________________________________________________________________ Second Choice: _____________________________________________________________________ Third Choice: _______________________________________________________________________ APPLICATION for ABORIGINAL STUDENT JOB SHADOW PROGRAM Page 6 WORKPLACE CHOICES Employer Positions Aquatera Utilities Eco Centre Waste Management Customer Billing / Metering Facility Maintenance Fleet System Parks Operations and Muskoseepi Park Transportation — Maintenance Horizon North Transportation Introduction to Transportation Norbord Woodlands Placement Seven Generations Energy Ltd. Exposure to all aspects of oil and gas production Weyerhaeuser Pulp Mill Technician Maintenance City of Grande Prairie (formerly Ainsworth) More to be opportunities announced! APPLICATION for ABORIGINAL STUDENT JOB SHADOW PROGRAM Page 7 PARENT / GUARDIAN CONSENT TO PARTICIPATE PARENT/GUARDIAN PERMISSION MUST BE PROVIDED TO APPLY FOR THIS PROGRAM. I am the parent/guardian of ______________________________________________, and I agree to his/her participation in the Aboriginal Student Job Shadow Program. I understand that requirements of the program include: 1. My child will stay at the GPRC dorms in Grande Prairie each week from Sunday to Friday evening, July 5 to August 14, 2015, under the supervision of GPRC staff; 2. I will ensure my child is dropped off at the GPRC dorms between 8 and 9 pm on Sundays — July 5, 12, 19, 26 and August 9, and Monday August 3; 3. I will ensure my child is picked up at the GPRC dorms between 5 and 6 pm every Friday from July 10 to August 14. 4. In case of emergency please contact: NAME: ____________________________________________________________ RELATIONSHIP TO STUDENT: ______________________________________________ HOME PHONE: _________________________ CELL: ________________________ I support my child’s participation in the program from July 5 to August 14, 2015. Parent/Guardian Name (please print): ___________________________________ Parent/Guardian Signature: ___________________________________ Date: ___________________________________ APPLICATION for ABORIGINAL STUDENT JOB SHADOW PROGRAM Page 8 PERMISSION TO PHOTOGRAPH I hereby authorize the partners of the Aboriginal Job Shadow Program, including but not limited to: the Indigenous Employment Coalition, Careers: The Next Generation, GPRC, Rupertsland Institute, Western Cree Tribal Council, Government of Alberta, Aquatera Utilities, City of Grande Prairie, Horizon North Logistics, Norbord, Seven Generations Energy Ltd., Weyerhaeuser Canada agents or the media to record and reproduce my likeness for us in stories about the Aboriginal Job Shadow program. Ownership of the visual image or reproduction will remain with the Aboriginal Job Shadow Committee. Student Signature: ______________________________ Date: ___________________ Parent/Guardian Signature:_______________________ Date: ___________________ (Parent or Guardian signature is required as students are younger than 18 years of age) If you or your parents have any questions about the program, please contact: Karen Scribner Program Coordinator, CAREERS: The Next Generation c/o Continuing Education Department, Office M 105, GPRC Phone: 780-539-2911 Email: kscribner@nextgen.org APPLICATION DEADLINE May 29, 2015
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