brant skills centre · submit checklist, referral form, application, and resume to the contact(s)...
TRANSCRIPT
Brant Skills Centre
Brant Skills Centre 225 Fairview Drive, Unit 1, Brantford, Ontario N3R 7E3
Phone: 519-758-1664 Fax: 519 -758-9394 Email: [email protected]
Website: www.brantskillscentre.org
Homeward Bound is an innovative program utilizing a collaborative wrap-around approach to assist low-income single mothers with breaking down barriers to create a path of economic opportunity and achievement of economic self-sufficiency. Delivered in four Phases over 4 years, the program components include academicand skills upgrading, a 2-year college diploma program, professional development, an internship and assistance with achieving gainful employment.
Homeward Bound Brantford-Brant is a collaborative effort of Brant Skills Centre, the City of Brantford and St.Leonard’s Community Services, and will be funded by the Ontario Trillium Foundation until March 2022. During this time, we will assist 15 low-income single mothers in the City of Brantford and the County of Brant with accessing community services and programs to break down barriers to education and employment.
We are ready to begin intake for the second cohort. Please use the attached Checklist & Referral form as yourguide to the program requirements. You can send the completed referral and application pieces together or separately. Self-referrals will also be accepted.
Referrals and application pieces should be submitted by the end of August.
• After we review the applications, applicants may be invited to an information session.
• We hope to begin conducting Academic Assessments during the months of July and August. Applicantswill need their high school transcript for these assessments. Please use the attached consent form if theapplicant attended high school in the Grand Erie District school board and would like Brant Skills Centreto access a copy of their transcript from Grand Erie Learning Alternatives (GELA) for free, on their behalf.If they attended outside of Grand Erie District please contact us for more information.
• Sign up for OneList for their childcare needs immediately at https://brantford.onehsn.com/
• Have up-to-date tax returns prior to applying for OSAP or childcare subsidy (if selected for the program).
• Aquire a Police Check (if selected for the program). This is not intended to discourage applicants, but tomake them aware that past criminal activity may influence their program and workplace options and toplan accordingly.
Please feel free to contact us if you have any questions.
Looking forward to receiving your referrals and applications,
Elisha Stuart and Lori [email protected] 519-758-1664
Brant Skills Centre
Applicants will need to:
Brant Skills Centre
Brant Skills Centre 225 Fairview Drive, Unit 1, Brantford, Ontario N3R 7E3
Phone: 519-758-1664 Fax: 519 -758-9394 Email: [email protected] Website: www.brantskillscentre.org
Consent for Brant Skills Centre to Access Transcript from GELA
I, ___________________________________(please print), give permission to Brant Skills Centre
to request my high school transcript from Grand Erie Learning Alternatives (GELA) on my behalf
for the purpose of completing academic assessments.
The last high school I attended was: ________________________________________________
The last year attended if known: eg. 2004____________________________________________
Date of Birth (DD/MM/YYYY): _____________________________________________________
Signature: _____________________________________________________________________
Date signed (DD/MM/YYYY): ________________________
Administrative Use Only
Date Consent Received by BSC (DD/MM/YYYY):
Brant Skills Centre
Page 1 of 2
Homeward Bound Brantford-Brant
Eligibility Checklist for Homeward Bound Brantford-Brant Referrals
Please use the checklist below to determine eligibility requirements for any referrals, including self-referrals.
In order to be eligible to apply for the program, all eligibility criteria listed below must be true.
If all statements are true, please complete the referral form on pg. 2.
Program Eligibility Checklist
Single mother 19+. Does not have a partner living with her.
Is a Canadian citizen, permanent resident, or convention refugee.
Has custody of at least one child under the age of 17 who is living with her.
Is not currently experiencing legal issues involving FACS.
Maximum of 3 children living with her.
Is substance abuse free for at least 1 year.
Has no current criminal proceedings.
Is able to participate in a full-time program.
The following criteria is preferred, but exceptions may be considered on a case-by-case basis:
Is receiving, or is eligible to receive OW or ODSP.
High school diploma, equivalent, or only 1-2 credits away from a diploma.
No previous post-secondary experience and/or unresolved OSAP debt.
Other eligibility criteria may apply.
NEXT STEPS:
1. Complete the referral form.
2. Complete an application and resume.
Send submissions or questions to Elisha Stuart or Lori Bruner:
Email: [email protected] Phone: 519-758-1664 Fax: 519-758-9394
3. Submit checklist, referral form, application, and resume to the contact(s) below.
PROCESS:
• Upon our receipt and review of submission, applicants may be asked to attend an information session.
• If selected to continue through the process clients will be asked to attend interview and assessment sessions.
• Interviews and assessments must be completed before a client will be considered a program candidate.
Page 2 of 2
Date
Referring Agency Information Agency
Contact Name
Phone Number
How long have you been working with this individual?
Why do you feel that this individual is suitable to undertake a 4 phase, multi-year commitment for the Homeward Bound program?
Client has given their permission to share their contact information.
Client has given their permission to share other personal information attached.
Client/Applicant InformationName
Phone Number
Date of Birth
Client/Applicant Consent to share contact and/or personal information
I, ____________________________ hereby give permission to Ontario Works Brant (OW) and/or Ontario
Disability Support Program (ODSP) to share my information with Brant Skills Centre; and to Brant Skills Centre to
communicate with OW and/or ODSP regarding my referral to the program. This information will be kept private
and strictly confidential.
Applicant Signature: Date: _______________
Witness Signature:
Administrative Use Only
Date Referral Received (DD/MM/YYYY):
Date Application Received (DD/MM/YYYY):
Homeward Bound Brantford-Brant Referral Form
* If self-referring, please complete date, client/applicant information, and consent components only.
Homeward Bound Brantford-Brant Application To be filled in by the applicant herself
1
Applicant Information
First Name: Last Name:
Date of Birth: mm dd yyyy
Home Phone:
Email:
Cell Phone:
Address:
City:
Apt. #:
Postal Code:
Is this housing:
Market rate rental
Subsidized rental
Other:
Shared with others Eg. Roomate
Marital Status:
Single
Married or Common Law
Separated
Divorced
Widowed
Other:
Citizenship Status:
Canadian citizen
Permanent Resident
Convention refugee
Other:
Current Source of Income (please check all that apply):
Ontario Works
Employment Insurance
Support Program (ODSP)
Child or Spousal Support Payments
Total Annual Gross Income (all sources):
Child Tax Benefit
No Income
Employment
Other:
Homeward Bound Brantford-Brant Application To be filled in by the applicant herself
2
Family Information
Number of children:
Number of children under the age of 17 in your legal custody and living with you:
Child # 1
First Name: Last Name:
Gender: Current Grade Level:
Date of Birth:
Day care: Child care subsidy:
Required Already have N/A Required Already have N/A
Child # 2
First Name: Last Name:
Gender: Current Grade Level:
Date of Birth:
Day care: Child care subsidy:
Required Already have N/A Required Already have N/A
Child # 3
First Name: Last Name:
Gender: Current Grade Level:
Date of Birth:
Day care: Child care subsidy:
Required Already have N/A Required Already have N/A
Comments:
Homeward Bound Brantford-Brant Application To be filled in by the applicant herself
3
Education & Skills
Highest level of education completed?
9
10
11
12 or OAC
GED
Post-secondary (please specify):
Country where educated:
How long have you been out of school?
Less than 1 year
1-3 years
4-6 years
More than 6 years
What were your reasons for leaving school?
Quit
Expelled
Completed/Graduated
Other (please explain):
How would you rate your computer skills? 1 is not very good and 5 is excellent. Please check.
Word 1 2 3 4 5
Excel 1 2 3 4 5
PowerPoint 1 2 3 4 5
Access 1 2 3 4 5
Email/Outlook 1 2 3 4 5
Internet 1 2 3 4 5
Please list any training, licences, or certificates that you have completed or obtained: (i.e. computer classes, cooking, sewing, driver’s licence, apprenticeships, etc.)
What form of transportation will you be using:
Public Transit Vehicle Other _____________
Which of the following college programs interest you?
Early Childhood Educator (ECE)
Practical Nursing
Health Office Administration
Social Service Worker
Business
Other (please explain):
Please list your top three program choices in order of preference.
1. 2. 3.
Homeward Bound Brantford-Brant Application To be filled in by the applicant herself
4
Employment
What is your current employment status: Employed Unemployed
Last or Current Employment (please also submit your resume with this application):
Company:
Title:
Start Date: End Date:
Reason for leaving: Quit Fired Other:
Comments:
Describe your greatest concern about the transition back to work and school? What do you think will be your greatest challenge?
Please check any of the following professional traits you think you may possess:
Good time management
Team player
Independent thinking
Flexible
Hard working
Good communication skills
Professionalism
Lifelong learner
Versatile
Articulate
Goal-oriented
Good planner
Organized
Good at multi-tasking
Other:
Please give an example of how you have applied one of the traits above:
Homeward Bound Brantford-Brant Application To be filled in by the applicant herself
5
Do you wish to identify any of the following as potential barriers to completing a post-secondary program and obtaining employment:
Interpersonal skills
English (ESL)
Attendance/Punctuality
Grooming
Motivation
Numeracy
Literacy Employment record
Education
Housing
Day care/Child care
Problems with authority
Have you ever been convicted of a criminal offence for which a pardon has not been granted?
Do you wish to identify any additional concerns?
What do you know about the Homeward Bound program? How does it align with your interests?
What would you bring to the program as a particpant?
Yes No
Homeward Bound Brantford-Brant Application To be filled in by the applicant herself
6
Goals
Identify goals for the next:
Six Months
/personal/
1. _________________________________________________________________________________
2. _________________________________________________________________________________
3. _________________________________________________________________________________
/professional/
1. _________________________________________________________________________________
2. _________________________________________________________________________________
3. _________________________________________________________________________________
Two Years
/personal/
1. _________________________________________________________________________________
2. _________________________________________________________________________________
3. _________________________________________________________________________________
/professional/
4. _________________________________________________________________________________
5. _________________________________________________________________________________
6. _________________________________________________________________________________
If accepted into the Homeward Bound program, what are your expectations?