Employer Registration Form
Business Information
Legal Name of Applicant
Mailing Address
Phone Number
Name of Contact Person
Total Number of Trainees
Male
Female
Total Funding Requested
Duration of Activity
Start Date:
End Date:
Training Objectives of Project:
Make objectives very clear.
Activities of Project:
List all activities and include a work plan schedule to justify the duration of the project.
Benefits to the Participant:
Address how this experience will assist the individual to gain ongoing employment.
Benefits to the Community:
Address how the project will address the local labour market needs.
Outcomes:
Expected results i.e. individuals have gained valuable work experience, community partnerships creating sustainable employment, project has long term job creation impacts upon completion.
Compensation:
CBSM requires employer to have WCB or equivalent coverage.
Col 1
Col 2
Col 3
Col 4
Col 5
Col 6
Col 7
Col 8
Col 9
Col 10
Job Title
Participants
#
of
Weeks
Total Work Weeks
Hours Per Week
Total Hours
Wage Rate
Subsidy % Request
Subsidy Request Per Hr.
GRETI Contrib. Requested
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Col 4x5
Col 7x9
Col 6x9
Training Costs
(Times, Dates and Fees are to be submitted)
Gross Cost - $
Total Training Costs
Equipment Lease/Rental Costs
(Please provide a minimum of 3 quotes)
Gross Cost - $
Total Equipment Costs
Special Costs
Gross Cost - $
Total Special Costs
Total GRETI Contribution >
Source(s) of other funds
Duration of Activity
From
To
Approved:
Yes
No
Approval Date:
Employer Information Requirements
Note:
All applicants are to complete the questions listed below. This will enable GREAT Staff to review and assess the training proposal. All submissions for financial assistance will not necessarily be approved as submitted. Therefore, further discussion and negotiations between the Applicant and GREAT Staff may be required in order to enter into an agreement.
Occupation
:
Hourly Wage:
Hours per Week:
Potential Start Date:
End Date:
Minimum Qualifications Desired for the Position: (Job description, if completed)
Mandatory Requirements for the Position:
Duties/Tasks the individual will Perform:
Will there be any training involved?
Yes
No
If yes, Please complete the next section:
Who will perform the training?
Name:
Credentials/Experience of Trainer:
Training Institution:
Certified/Accredited:
Will you require the services of GREAT staff to assist with Recruitment and Selection of an individual?
Yes
No
If no, please explain why:
Will the individual be employed on a full-time basis upon completion of the contract?
Yes
No
If no, please explain why:
Will the individual have benefits
(i.e. E.I.., formally U.I.C.P.P. etc.)
taken out of their pay?
Yes
No
If yes, what is your Revenue Canada Taxation Number?
Do you currently pay Workman Compensation Benefits (WCB) or any similar Liability Insurance?
Yes
No
Number of Employees:
Have you participated in one of GREAT's Employment Program?
Yes
No
Results:
(Please explain)
