Intake Form | Prairie Skills

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Our mandate is to assist rural Manitoba residents. In particular, those who are unemployed, under-employed or at risk of becoming unemployed, to prepare for, find, and maintain employment by providing a variety of short-term, employment-related services.

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Client Intake Form

First Name

Last Name

Date of Birth

Gender

Male

Female

Other

Not Declared

How did you find out about us?

Outside agency that referred you to us

Preferred Language

Address

Province

Postal Code

Email (if you do not have an email address call us at 204-747-2610)

Contact Phone Number

Current Employment Status

Employment information

Do you have any volunteer or unpaid work experience?

Highest Level of Education

Grade 9, 10, 11

High School Diploma

Journey Person/Red Seal

College Graduate

University Degree

Other

Year Education Completed?

Education- Degree or Certificates

Are you Indigenous?

Are you receiving any of the following

Marital Status

Single

Married or Equivalent

Not Declared

Do you have dependents?

Number of Dependants

Do you have a Disability?

Are you a visible minority?

Are you an Immigrant/Refugee?

Landing Year

How Can We Help You?

How would you prefer us to contact you?

What Job Fields Interest You?

Healthcare

Retail or Hospitality

Private Farm

General Farm Labour

Cleaning

Childcare

Oil and Gas Industry

Accounting/Bookkeeping

Trades Work

Heavy Equipment Operator

Landscaping/Green Team

General Labour

Office Administration

Class 1A Driving

Beauty Industry

Driving

Other

What other information should we know?

Would You Like to Receive our Weekly Job Board?

Yes

No

Level of Employment Urgency?

I agree with Prairie Skills contacting me based on my employment urgency for a minimum of 90 day or longer if required?

Upload Your Resume

Or email admin@prairieskills.comm

View Terms and Conditions

I agree to the terms and conditions

A copy of the terms and conditions will be emailed to you for your records.

The services we provide are available if you are legally entitiled to work in Canada.
The information you provide will help us, help you!
Once we receive your information one of our Client Advisors will be in touch to set up an appointment.

Thanks for submitting!

Prairie Skills Employment Services

admin@prairieskills.com

204-747-2610

We are open to in-person appointments and will also continue to supply the services you are needing in a remote manner.

220 South Railway Ave W, Deloraine, MB

Funding Provided by

The Government of Canada

The Manitoba Government

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