INTAKE FORM | Trivantage Learning Academy

First name

Last name

Phone

Email

Multi-line address

Country/Region

Address

City

Zip / Postal code

Gender:

Male

Female

X

(NEWCOMERS ONLY) COUNTRY OF ORIGIN

(NEWCOMERS ONLY) DATE OF ARRIVAL IN CANADA (MONTH/DAY/YEAR)

PREVIOUS WORK EXPERIANCE

EDUCATION BACKGROUND

Have you attended other LINC classes? (NEWCOMERS ONLY)

Yes

No

If yes, please specify:

Do you have a Language Companion? (NEWCOMERS ONLY)

Yes

No

Date Intake: (Month/Day/Year) (NEWCOMERS ONLY)

Assessment Date: (Month/Day/Year) (NEWCOMERS ONLY)

CLB (Listening, Speaking, Reading, Writing): (NEWCOMERS ONLY)

Listening

Speaking

Reading

Writing

NEWCOMERS/SETTLEMENT & INTEGRATION

Computer Literacy - $299 + HST

Career Pathway/Job-Readiness Workshops - $299 +HST

English as a Second Language $ 250 + HST monthly for 3 months / $225 + HST monthly for 6 months

Financial Literacy for Newcomers - $299 + HST

Civic Engagement Pathway to Citizenship Courses - $299 + HST

IELTS - International English Language Testing System (TBD)

HEALTHCARE & COMMUNITY COURSES

Gentle Persuasive Approach (GPA) - $150 +HST each ($1299 for 10+group + HST)

Palliative Care - PSW - $299 + HST

Analytical Testing Laboratory Equipment Training (TBD)

IENs - Internationally Educated Nurses (TBD)

BUSINESS PROGRAMS

Accounting & Bookkeeping Level 1 & 2 - $375 each level + HST

QuickBooks Online Basics Level 1 & Level 2 - $ 375 each level +HST

Payroll Administration - $575 + HST

MICRO-CREDENTIALS & PROFESSIONAL DEVEOPMENT

Lean Six Sigma - $250 each level +HST

Emotional Intelligence - $350 +HST

Certified Coach - $2100 + HST

Project Management - $2100+ HST

Adult Education Certification - $2100 + HST

WHMIS - $375 + HST

Food Handlers Course $150 + HST

Do you have any special needs we should be aware of?

I, hereby, give permission to be photographed and/or videotaped, and for these media to be published or displayed along with my name, nationality, and the organization I am attending. These may be used for promotional and informational purposes by Trivantage Learning Academy (e.g., newspapers, brochures, online media).

By typing my name and date. I acknowledge that i have read, understood, and agree to the terms outlined in the above statement

Please type in your full name and date.

PAYMENT

E-tranfer to: admin@trivantagelearningacademy.ca

Receipt will be provided.