Eligibility checklist for TechWORKS TechWORKS - Application Form In order to determine your eligibility for the TechWORKS, please answer the following questions (you may be asked to provide supporting documentation):Name:*Phone Number:*Email* Which program are you looking to apply for:TechWORKS for YouthTechWORKS for Young AdultsTo qualify for TechWORKS for Youth you must meet: 15 – 29 years of age Unemployed or working less than 30 hours per week Living in the mid-island between: Nanaimo/ Port Alberni/ Mill Bay/ Cowichan Valley/ Parksville-Bowser To qualify for TechWORKS for Young Adults you must meet: 18 – 24 years of age Living on Vancouver Island Unemployed or precariously employed 1) I am between the ages of 15 and 29, inclusive:*YesNo1) I am between the ages of 18 and 24, inclusive:*YesNoIf yes: How old are you?*Please enter a number from 15 to 29.If yes: How old are you?*Please enter a number from 18 to 24.2) I am unemployed.* “Unemployed means you are available for work but do not have work and includes those: • who are on temporary layoff with an expectation of recall • who have actively looked for work in the past four weeks or • who have a new job to start within four weeks.” YesNo3) If employed, I am working less than 30 hours a week, on average.*YesNoNot Applicable / UnemployedIf you are working, do not quit your job as this may affect your eligibility for the program.4) Are you receiving Employment Insurance?* NOTE: If you have worked and may have enough hours to qualify, you will need to apply. You are to contact Service Canada and disclose your intended purpose to participate in the TechWORKS program including providing Service Canada with the length of the training. It is up to you to manage your relationship with Service Canada and any impact your participation in the program may have on your active claim. YesNo5) Are you on Income Assistance, or classified as Person with Disability?*YesNo6) I am legally entitled to work in Canada.*YesNo7) I am currently living in:*• Nanaimo, Chemainus, Cobble Hill, North Cowichan, Duncan, Gabriola, Ladysmith, Lake Cowichan, Mill Bay, Cedar, Parksville and Port Alberni YesNoIf not: Are you living on Vancouver Island?*YesNoPlease provide your address:* Street Address City Postal Code 8) I am currently a full-time student or enrolled in high school.*YesNo9) I am currently participating in another government-funded program.*YesNoIf yes, please enter name of program:*Do you have access to a computer?*YesNoDo you have access to a webcam?*YesNoWhat is your preferred contact method?*E-mailPhone10) How did you learn about the TechWORKS PROGRAM?