APPLICATION for ABORIGINAL STUDENT JOB SHADOW PROGRAM
Page 1
ABORIGINAL STUDENT
JOB SHADOW PROGRAM (G.P.)
Application Package
Presented by the Indigenous Employment Coalition
APPLICATION for ABORIGINAL STUDENT JOB SHADOW PROGRAM
Page 2
Please read the Student Information Package prior to applying for
this program.
Submit your application directly to:
Karen Scribner
Program Coordinator, CAREERS: The Next Generation
c/o Continuing Education Department, Office M 105, GPRC
Fax: 780-539-2791
Email: [email protected]
Applications must be received no later than May 29, 2015.
Due to the anticipated volume of applications, only students selected
for interviews will be contacted.
Thank you for your interest in the Aboriginal Job Shadow Program.
NAME: ________________________________ GENDER (please check):
ADDRESS:
Male ___
Female ___
___________________________________________________________________________
HOME PHONE: _____________________________
CELL PHONE:
_____________________________
Email Address: ___________________________________________________________________________
DATE OF BIRTH: ______________________________ Students in this program must be 15 to 17 years of age
SIN # (or date you applied for a SIN): ____________________________ Required for pay during the program
Alberta Student Number ______________________________________ Available on report card or from school
Have you previously applied to this program? Yes ___ No ___
Do you have a Class 7 (Learners) License?
Yes ___ No ___
Are you? (Please check only one):
___
First Nations
___
Metis
___
Inuit
___
Other Aboriginal
Indicate Band ___________________________________________________
Specify
__________________________________________________
Are you currently living on a reserve? Yes ___ No ___
If yes, name of Reserve _________________
Are you currently attending school?
Name of School _______________________
Yes ___ No ___
Current Grade Enrolled or Last Grade Completed
______________
APPLICATION for ABORIGINAL STUDENT JOB SHADOW PROGRAM
Page 3
Please ensure all information is provided.
This information will assist in determining your suitability for
the program. The information will be kept confidential and
destroyed at the end of the program.
Please note: this program is for students, and is not intended
for people who are already working full-time.
Have you taken the Work Experience Pre-Requisite Course?
(HCS 3000 — Workplace Safety Systems)
Yes ___
No ___
Have you taken any other career related training?
Yes ___
No ___
If yes, what did you take?
___________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
We get a lot of applications for this program, so it is very important that you answer the next
questions in great detail. Students are chosen for an interview based on how much detail and
information you provide in your answers. If you require more room to answer the questions,
please feel free to write on the back of the pages.
What employment or volunteer experiences have you had (part-time or full-time)?
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Why are you interested in participating in this program?
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
APPLICATION for ABORIGINAL STUDENT JOB SHADOW PROGRAM
Page 4
Why are you interested in participating in this program?
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Please indicate why you would be a good candidate for this program.
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Please give a short description of your personal and future goals. What do you want to do when
finished school?
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Do you have any special needs that we need to accommodate during the program? (For example: medical
conditions, medications taken, allergies, etc.)
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
APPLICATION for ABORIGINAL STUDENT JOB SHADOW PROGRAM
Page 5
IMPORTANT INFORMATION
The program runs from July 5 to August 14. You are expected live at the
GPRC dorms from Monday to Friday every week, and go home on the
weekends. Even if you live in Grande Prairie you must stay in the dorms
during the weekdays for the duration of the program.
As students are under the age of 18, no student may use or possess
cigarettes, tobacco, tobacco products, e-cigarettes, alcohol or illegal
drugs at any time!
There is a $400 per week training allowance provided to students
accepted into the program, a $400 completion bonus for students who
complete the 6 week program, and CEU credits may go toward high
school graduation credits for participation in the program.
Please see the Student Information Package for descriptions of positions
available and other important information about the program. If you or
your parents have any questions about the program, please contact:
Karen Scribner
Program Coordinator,
CAREERS: The Next Generation
c/o Continuing Education Department
Office M 105, GPRC
Phone: 780-539-2911
Email: [email protected]
APPLICATION DEADLINE = May 29, 2015
WORKPLACE CHOICES
Please read the Student Information Package and indicate which Job Shadow Positions you are most
interested in. Please note: some employers rotate you through several positions.
First Choice: _______________________________________________________________________
Second Choice: _____________________________________________________________________
Third Choice: _______________________________________________________________________
APPLICATION for ABORIGINAL STUDENT JOB SHADOW PROGRAM
Page 6
WORKPLACE CHOICES
Employer
Positions
Aquatera Utilities

Eco Centre

Waste Management

Customer Billing / Metering

Facility Maintenance

Fleet System

Parks Operations and Muskoseepi Park

Transportation — Maintenance
Horizon North Transportation

Introduction to Transportation
Norbord

Woodlands Placement
Seven Generations Energy Ltd.

Exposure to all aspects of oil and gas
production
Weyerhaeuser

Pulp Mill Technician

Maintenance
City of Grande Prairie
(formerly Ainsworth)
More to be opportunities announced!
APPLICATION for ABORIGINAL STUDENT JOB SHADOW PROGRAM
Page 7
PARENT / GUARDIAN CONSENT TO PARTICIPATE
PARENT/GUARDIAN PERMISSION MUST BE PROVIDED TO APPLY FOR THIS PROGRAM.
I am the parent/guardian of ______________________________________________,
and I agree to his/her participation in the Aboriginal Student Job Shadow Program. I understand that requirements of the program include:
1.
My child will stay at the GPRC dorms in Grande Prairie each week from Sunday to
Friday evening, July 5 to August 14, 2015, under the supervision of GPRC staff;
2.
I will ensure my child is dropped off at the GPRC dorms between 8 and 9 pm on
Sundays — July 5, 12, 19, 26 and August 9, and Monday August 3;
3.
I will ensure my child is picked up at the GPRC dorms between 5 and 6 pm every
Friday from July 10 to August 14.
4.
In case of emergency please contact:
NAME:
____________________________________________________________
RELATIONSHIP TO STUDENT: ______________________________________________
HOME PHONE:
_________________________ CELL: ________________________
I support my child’s participation in the program from July 5 to August 14, 2015.
Parent/Guardian Name (please print):
___________________________________
Parent/Guardian Signature:
___________________________________
Date:
___________________________________
APPLICATION for ABORIGINAL STUDENT JOB SHADOW PROGRAM
Page 8
PERMISSION TO PHOTOGRAPH
I hereby authorize the partners of the Aboriginal Job Shadow Program, including but not
limited to: the Indigenous Employment Coalition, Careers: The Next Generation, GPRC,
Rupertsland Institute, Western Cree Tribal Council, Government of Alberta, Aquatera
Utilities, City of Grande Prairie, Horizon North Logistics, Norbord, Seven Generations
Energy Ltd., Weyerhaeuser Canada agents or the media to record and reproduce my
likeness for us in stories about the Aboriginal Job Shadow program. Ownership of the
visual image or reproduction will remain with the Aboriginal Job Shadow Committee.
Student Signature: ______________________________ Date: ___________________
Parent/Guardian Signature:_______________________ Date: ___________________
(Parent or Guardian signature is required as students are younger than 18 years of age)
If you or your parents have any questions about the program, please contact:
Karen Scribner
Program Coordinator, CAREERS: The Next Generation
c/o Continuing Education Department, Office M 105, GPRC
Phone: 780-539-2911
Email: [email protected]
APPLICATION DEADLINE
May 29, 2015