Eligibility & Application Form

Your Name*

Phone*

Email*

Age*

I am Unemployed*

Yes
No

“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, have actively looked for work in the past four weeks or have a new job to start within four weeks.”

If employed, I am working less than 30 hours a week, on average.*

Yes
No

If you are working, do not quit your job as this may affect your eligibility for the program.

I am receiving Employment Insurance.*

Yes
No

I am on Income Assistance*

Yes
No

I am classified as a person with a disability*

Yes
No

I am legally entitled to work in Canada.*

Yes
No

I am currently living on Vancouver Island.*

Yes
No

You must provide two pieces of ID to verify; one piece must be Photo ID.

What city do you live in?

I am currently a full-time student or enrolled in high school.*

Yes
No

I am currently participating in another government-funded program.*

Yes
No

Name of Program:

Have you applied to any other ETHOS programs?*

Yes
No

Name of Program:

How did you learn about RiseUp?*

I have access to a computer*

Yes
No

I have access to a webcam*

Yes
No

Hidden

Date Submitted (DD/MM/YYYY)