Application for Culinary Employment Skills Program A Partnership between Christian Horizons and Humber College PLEASE HAVE APPLICATIONS IN BY AUGUST 8 TH THERE ARE 15 SPACES AVAILABLE Application Eligibility: 18 years of age or older and a Canadian citizen or landed immigrant Have a developmental disability Desire to work full time, part time or be self-employed in the food industry Ability to work semi-independently Ability to obtain or have access to transportation (to work placements, Humber College rth Campus and 155 Deerhide Cres) Please see the last 2 pages of this application for additional course information All information on this form will be held in confidence. Date: LAST NAME: DATE OF BIRTH: / / AGE: ( ) dd / mm / yyyy FIRST NAME: ADDRESS: APT #: CITY: PROVINCE: POSTAL CODE: - PHONE #: ( ) - CELL PHONE #: ( ) - WORK PHONE #: ( ) - Ext. E-mail address: SIN #: - - Are you legally eligible to work in Canada? If not eligible, please provide details: EMERGENCY CONTACT: RELATIONSHIP: EMERGENCY PHONE #: ( ) - Ext. FIRST LANGUAGE: CITIZENSHIP STATUS: PRIMARY CAREGIVER: Parent Self Other Specify: OTHER LANGUAGES: RELIABLE TRANSPORTATION: How will you be getting to/from program? CURRENT RESIDENTIAL SITUATION: Family Home Own Home Relatives Group Home Other Specify: Lives with: 1
Please tell us how you heard about this program: Referral Source: (Name/Position) Organization: Telephone: Ext. Fax: Email: Developmental Diagnosis?: Unknown If YES, please describe: Taking Medication?: Unknown Medication changes in last 6 months?: Unknown If YES to either, please indicate if you can safely operate equipment (side effects), do you self-administer and any information that might be relevant: Does applicant have allergies, diabetes, epilepsy, Hepatitis B, etc?: Unknown If YES, please describe: History of behavioural concerns (eg. verbal/physical aggression, weapons threat or use, violence towards self/others?): Unknown If YES, please describe: Can the applicant work safely in a professional kitchen (gas stoves, fryers, knives)?: Unknown Please provide relevant information: 2
SOCIAL SUPPORT Current Support Past and Present Type of Support: Home/self Agency Name (family/friend): Tel: Ext. How long? Address: Permission to contact? Name of Agency: Tel: Ext. How long? Address: Contact: Permission to contact? Receiving Income Support? Please indicate as applicable: 1. ODSP 2. Ontario Works 3. Employment Insurance 4. Workplace Safety and Insurance 5. Canada Pension Plan 6. Accident, Sickness, Disability Insurance 7. Self 8. Support from family 9. Other; Please describe: EDUCATION Name of School level of education completed Completed Elementary School Completed Secondary School Completed College Post-Secondary Other Training or Programs Completed: CO-OP AND/OR VOLUNTEER EXPERIENCE 3
Dates Job Title / Duties Company Reason for Leaving WORK HISTORY (Please specify in detail) Dates Job Title / Duties Company Reason for Leaving ADDITIONAL INFORMATION Do you require any accommodations while in the workplace? Please specify. 4
Are you available for the full 9 months that the program runs? (Excluding Christmas Break and Reading Week). Can you attend every Tuesday to Saturday? Are you flexible in your hours of availability to attend class and placement? For example, placements may occur at a different start and finish time than classroom sessions. Why do you want to attend this program? Once the application is received it will be reviewed and a time will be arranged with the applicant for an initial phone interview. Upon successful completion of the phone interview a personal interview will be arranged. Name of Person Completing this Application: (Please print) Signature of Applicant: Send the completed application to: Attention Judith Huh, Employment Coordinator-Christian Horizons Fax: 416-630-2579 Or Email: jhuh@christian-horizons.org 5
Christian Horizons in partnership with Humber College introduces Culinary Employment Skills Are you looking for an exciting opportunity to expand on your passion for the culinary arts? Our partnership with Humber College provides you with the opportunity to learn hands on skills under the guidance of industry professionals in the state of the art kitchen at Humber College. Course Highlights Eligibility 18 years of age or over Developmental Disability Desire to work in food services Ability to provide own transportation daily Independent Available September to June Committed to attend Tuesday through to Saturday every week Flexibility with hours Employment readiness through classroom training Unpaid placements in various food services establishments Extensive assessment and feedback Hands on training from professional chefs Beginning September 2014 Weekly Schedule Sunday Monday Tuesday Wednesday Thursday Friday Saturday OFF OFF 155 Deerhide Cres Internship Internship Internship Humber College (rth Campus) 6
About the Program Employment soft skill learning every Tuesday at Christian Horizons location at 155 Deerhide Cres Example of some sessions: WHIMS First Aid Smart Serve (optional) Health and Safety Cashier Training Resume Writing Interview Skills Placement Opportunities Wednesday to Friday Hands-on kitchen training Saturdays at Humber College Contact Information Judith Huh jhuh@christian-horizons.org (416) 630-3646 Ext 5243 How to Apply: Fax or email application to Attention: Judith Huh, Employment Coordinator Fax: 416-630-2579 Email: jhuh@chrisian-horizons.org 7