The Client Application Form can be filled out
and submitted electronically. Fill out all the information below and
Sioux-Hudson Employment Services will contact you.
All the information
will remain confidential, however, some information may be disclosed for
statistical purposes to Service Canada or to determine eligibility.
Client Name:
Street Address:
Post Office Box:
City:
Province:
Postal Code:
Phone Number:
Email Address:
Date of Birth:
Gender:
Social Insurance Number:
Education level completed:
Province education obtained
in:
Are you planning to return to school in the fall?
Are you currently employed?
If yes, full or part time?
If part time, how many hours
per week?
Have you applied for benefits?
If yes, date that you applied:
Are you in receipt of Employment Insurance now?
Have you worked 420 hours or more in the last 12 months?
If yes, last day which you worked:
Have you received EI in the last 3 years?
Have you been on parental or maternity benefits in the last 5 years?
Have you participated in a Service Canada program in the past?
Are you Aboriginal?
If yes, are you Status Indian, Non-Status, Metis, Inuit, Other
Do you feel that you have a disability?
What kind of work or training are you looking for?
Comments or Questions:
Please press this button to submit your application. Thank you.
Sioux-Hudson Employment Services 70 Wellington Street
(formerly Wellington School)
Box 126, Sioux Lookout, ON P8T 1A1
Phone:
(807)
737-1672
Fax: (807) 737-4685
Office Hours:
Monday to Friday
8:30 a.m. - 4:30 p.m.
Hudson Office:
Our Hudson office is open Wednesday mornings from 9:00 to 11:15 in the
Patricia Centre. Please call ahead to the Sioux Lookout office if you require something
special.
This
initiative is funded
by the Government of
Canada's
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Sioux-Hudson
Employment Services 
Sioux-Hudson Employment Services