ISET Client Application

Step 1 of 12

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Applicant details

What is your Province/Territory of residence(Required)

Social Insurance Number (SIN)(Required)

Example: 564 343 332

Name(Required)

Title First Middle Name(s)/Initials Last

Contact information

Address(Required)

No PO boxes

Street Address Address Line 2 City Province or Territory Postal Code

Is your Mailing Address different from listed above?(Required)

Yes

Mailing Address

Street Address Address Line 2 City Province Postal Code

Daytime Phone #(Required)

Example: (305)-734-5834

Alternate phone #

Example: (305)-734-5834

Email(Required)

Example: main@email.com

Emergency Contact Name(Required)

Example: Jane Doe

Emergency Contact Phone(Required)

Example: (305)-734-5834

Relationship to Applicant(Required)

Gender(Required)

Female

Gender Diverse

Date of Birth(Required)

Example: 1990/02/21

YYYY slash MM slash DD

Indigenous Group(Required)

Status First Nation

Non-status First Nation

Métis

Inuit

First Nation/Inuit/Metis Number(Required)

Example: FN837194625

Home Community(Required)

Example: Peguis First Nation, etc.

Marital Status(Required)

Married or equivalent (spouse’s name required)

Single

Separated

Divorced

Widowed

If married or equivalent, spouse's name(Required)

Do you have dependent children under the age of 12(Required)

Yes

If yes, please list ages of children(Required)

Example: 2,5,8

Do you consider yourself to have a disability?(Required)

Yes

Nature of disability(Required)

Are you currently receiving Social Assistance or EIA(Required)

Yes

Have you advised your Case Worker that you are applying to the ISET program?(Required)

Yes

If yes, what is your allowable “top-up” (if applicable)?(Required)

What is your current employment status?(Required)

Unemployed

Under-employed

Employed Full-time

Employed Part-time

Self-Employed

Full time student

Part time student

Other

Education

Education: (select all that apply)(Required)

No formal education

Up to grade 7-8 (Secondaire I-II)

Grade 9-10 (Secondaire. III)

Grade 11-12 (Secondaire IV – V)

Secondary School Diploma or GED

Some post-secondary training

Apprenticeship/ trades certificate or diploma

CEGEP or other non-university certificate/diploma

College or other non-university certificate/diploma

University certificate or diploma

University – Bachelor Degree

University – Masters degree

University – Doctorate

Years Completed: Up to grade 7-8 (Secondaire I-II)(Required)

Years Completed: Grade 9-10 (Secondaire. III)(Required)

Years Completed: Grade 11-12 (Secondaire IV – V)(Required)

Years Completed: Secondary School Diploma or GED(Required)

Years Completed: Some post-secondary training(Required)

Years Completed: Apprenticeship/ trades certificate or diploma(Required)

Years Completed: CEGEP or other non-university certificate/diploma(Required)

Years Completed: College or other non-university certificate/diploma(Required)

Years Completed: University certificate or diploma(Required)

Year Completed: University – Bachelor Degree(Required)

Years Completed: University – Masters degree(Required)

Years Completed: University – Doctorate(Required)

Year in which highest level of education was attained(Required)

Province/Territory in which highest level of education was attained(Required)

Employment goals

What is your long-term employment goal as it relates to ISET funding?(Required)

What challenges are making it hard for you to reach your employment goals (select all that apply)(Required)

Education

Funding

No job opportunities in my chosen field

Location (remote community)

Language

Lack of work experience or marketable skills

Other (please specify)

If other, please specify(Required)

If eligible, what financial supports would you need to help reach your employment goals?(Required)

Training or education expenses (Tuition/books/materials/residence fees/meal plan, etc)

Monthly living expenses (rent, utilities, groceries, transit pass)

Childcare: (Is a childcare subsidy being requested)(Required)

Yes

Childcare Funded: (Support currently received)(Required)

Not applicable

FNICCI

Assisted by family

EI/CRF

No funding received

Self-funded

Provincial funding/subsidy

Daycare not available

Will your childcare expenses increase as a result of starting your education, training or work placement?(Required)

Yes

Are you currently receiving or have you applied to receive any funding from the following:(Required)

Not applicable

Band funding

Student loans repayable

Student loans non-repayable

Entrance scholarships

Grants/Bursaries/Awards

Other ISET Holder, Indigenous Agency or Organisation

Other not listed above (please specify):

If other, please specify(Required)

If yes, please specify which program

If yes, please specify the amount

Applicants to NWAC’s ISET program are required to complete this application and attach the following documents:

Do you have a Status/Treaty card?(Required)

Yes

Status/Treaty Card Front(Required)

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

Status/Treaty Card Back(Required)

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

If you do not hold a Status/Treaty card, please describe why(Required)

(e.g, in process, not eligible, other)

One other Government-issued ID Front(Required)

Accepted ID’s: Driver’s License, Passport, etc.

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

One other Government-issued ID Back(Required)

Accepted ID’s: Driver’s License, Passport, etc.

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

Do you have a Letter of Acceptance?(Required)

Yes

Letter of Acceptance(Required)

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

If you do not have an acceptance letter from an educational/training institution, please explain your situation(Required)

Do you have a Band Funding or Denial Letter?(Required)

Yes

Band Funding or Denial Letter(Required)

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

If you do not have a letter from your Band/Nation, please explaing your situation(Required)

Additional supporting documentation will be requested upon receipt of your application. Your information will be kept confidential in accordance with Canadian privacy laws upon submission and will not be used or disclosed for purposes other than those for which it was collected.

CLIENT CONSENT FOR EI VERIFICATION

CLIENT CONSENT FOR EI VERIFICATION(Required)

I, the undersigned, give my expressed and informed consent to the Native Women’s Association of Canada and/or its sub-agreement holders to the Indigenous Skills and Employment Training Program (hereinafter referred to as SET), to collect personal or sensitive information as it relates to my request for funding under the ISET program funded by Employment and Social Development Canada (ESDC). My consent extends to providing my Social Insurance Number (SIN), to determine my eligibility for interventions such as skills training and wage subsidies as part of the Labour Market Development Agreements (LMDA) program.

I acknowledge that the information is collected and administered in accordance with the Privacy Act (R.S.C. 1985, c P-21), the Department Employment and Social Development Canada Act (S.C. 2005, c.34), and the Access to Information Act (R.S.C., 1985, c.A-1). Information collected is to be used to determine eligibility for the ISET program; to measure results of this Agreement and evaluate its success; evaluate the effectiveness of the Program in achieving its objective; and, to meet its obligations of accountability by reporting on the results of the Program.

All information referred to above shall be treated as confidential, and the Native Women’s Association of Canada and its sub-agreement holders will take all security measures reasonably necessary for the protection of such information against unauthorized release or disclosure.

Further, I understand that my personal information shall not be used or disclosed for purposes other than those for which it was collected, except with the expressed consent of you, as the client, or as required by law. Personal information shall be retained only as long as necessary for the fulfilment of those purposes

I agree to the privacy policy.

Signature(Required)

ISET Financial Overview

To qualify for ISET funding, applicants must disclose ALL household income from all sources. Documentation and proof of financial situation IS REQUIRED prior to any approval of funding.

MANDATORY: If you are in receipt of social assistance, you MUST provide a letter from your caseworker indicating how much you are receiving monthly and the amount of ‘top up’ you may be eligible to receive as a living allowance while attending an eligible training or educational program.

Your ISET application WILL NOT be processed until this form is completed and all verification documents have been submitted in support of your application for a living allowance.

Are you currently employed?(Required)

If you are currently employed, you MUST provide copies of your last 3 paystubs

Yes

Upload copies of your last 3 paystubs(Required)

1 of 3

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

Upload copies of your last 3 paystubs(Required)

2 of 3

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

Upload copies of your last 3 paystubs(Required)

3 of 3

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

Are you currently married or equivalent?(Required)

If you are married, or equivalent, you MUST provide: Copies of your partner’s last 3 paystubs.

Yes

Upload Copies of your partner’s last 3 paystubs.(Required)

1 of 3

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

Upload Copies of your partner’s last 3 paystubs.(Required)

2 of 3

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

Upload Copies of your partner’s last 3 paystubs.(Required)

3 of 3

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

Do you have dependent children under the age of 18?(Required)

If you have dependent children under the age of 18, you MUST provide a copy of the latest child tax benefit statement.

Yes

Upload a copy of your latest child tax benefit statement*(Required)

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

Are you applying for Living Allowance?(Required)

Yes

Monthly / Total Expenses

Rent/Mortgage(Required)

Please enter a number from 0 to 100000.

Total amount for all utilities (Hydro, water, natural gas, sewer, garbage)(Required)

*Cable, internet and cell phones are not included in this amount

Please enter a number from 0 to 1000000.

Groceries(Required)

Please enter a number from 0 to 100000.

Monthly transit pass(Required)

Please enter a number from 0 to 100000.

Childcare(Required)

Please enter a number from 0 to 100000.

Upload 3 months of utilities(Required)

1 of 3

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

Upload 3 months of utilities(Required)

2 of 3

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

Upload 3 months of utilities(Required)

3 of 3

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

Upload Lease/Mortage statement(Required)

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

Upload Childcare documents(Required)

Accepted file types: pdfs, jpeg, png, jpg, pdf, Max. file size: 5 MB.

Income Sources /Monthly Income from all Sources

Employment Income(Required)

Please enter a number from 0 to 100000.

Spousal Income(Required)

Please enter a number from 0 to 100000.

Social Assistance(Required)

Please enter a number from 0 to 100000.

Child Tax Benefit(Required)

Please enter a number from 0 to 1000000.

Jordan’s Principle(Required)

Please enter a number from 0 to 100000.

Band Funding(Required)

Please enter a number from 0 to 100000.

Pension/Disability Amounts(Required)

Please enter a number from 0 to 100000.

Other: please specify

Please enter a number from 0 to 100000.

* * Living allowance is a subsidy and not intended to cover all monthly expenses or a deficit, while attending an eligible training or educational institution.

By signing below, I confirm that the above information is true and I understand that providing false or misleading information may make me ineligible for funding through the ISET program and may result in a repayment of funds to Employment and Social Development Canada (ESDC), if I received funding to which I was not entitled.

Signature(Required)

Indigenous Self-Declaration(Required)

I, the undersigned, understand that the funding opportunity under the Indigenous Skills and
Employment Training (ISET) program for which I am being assessed is intended to increase Indigenous
participation in the Canadian labour market and support First Nations, Metis and Inuit peoples’ access to
sustainable and meaningful employment. The ISET program provides access to training and employment
supports to eligible Canadian Indigenous women in their diversities, including status and non-status First
Nations, Metis and Inuit peoples whether residing on or off-reserve, in urban centres and in rural,
remote communities.

Further, I understand that providing false or misleading information and/or omission of information by
me about my Indigenous identity may result in an investigation. If an investigation is founded, it will be
grounds for immediate suspension of any funding provided or promised to me and further, revocation
of any Funding Agreement signed between me and the Native Women’s Association of Canada and/or
its sub-agreement holders, and will result in a repayment of funds to Employment and Social
Development Canada (ESDC), for monies I received to which I was not entitled.

I hereby declare that I am an Indigenous person in Canada, which for the purposes of the Indigenous Skills and Employment Training (ISET) Program is inclusive of persons who are First Nations, Inuit, or Métis.

My Nation/Community/Treaty Area affiliation is:(Required)

(e.g, Mohawk of kahnawa:ke; Inuit of Nunatsiavut; Métis Nation of Alberta, Region 3, etc.)

Client Name (Printed)(Required)

Client Signature(Required)

Client Acknowledgement of Funding Source(Required)

I, the undersigned, acknowledge that I have been advised by the Native Women’s Association of Canada and/or its sub-agreement holders to the Indigenous Skills and Employment Training Program (hereinafter referred to as ISET) that funding for skills and employment training, living allowance, wage subsidies or other sources of funding are Government of Canada resources advanced through Employment and Social Development Canada (ESDC) to fund the ISET program.

I give my consent to the Native Women’s Association of Canada and/or its sub-agreement holders and their designated authorized representatives, to contact other service agencies, funding providers, educational and training institutions to verify information regarding my application and for verification of household income sources.

Requests for supporting documentation may include but is not limited to: acceptance letter from training institution, letter of decision by Band; ID (Status/Treaty Card, driver’s license, Passport, Health Card or other Government-issued identification); tax assessments; child tax benefit (CTB) statement; Social Assistance statement or letter from agency/caseworker; Record of Employment (ROE); paystubs; letter of employment, bank statements, and other documentation as may be required for verification purposes.

I understand and acknowledge that any false or misleading statements and/or omission of information by me, may be grounds for immediate suspension of any funding and further, revocation of any funding arrangement between me and the Native Women’s Association of Canada and/or its sub-agreement holders, and may result in a repayment of funds to Employment and Social Development Canada (ESDC), for monies I received to which I was not entitled.

I agree with the acknowledgement of funding sources.

Client Signature(Required)

Consent Form for Use of Image, Video, Audio(Required)

I, the undersigned, hereby give my expressed and informed consent to the Native Women’s Association of Canada (hereinafter referred to as NWAC), and/or its sub-agreement holders to the Indigenous Skills and Employment Training Program (hereinafter referred to as ISET), permission to use my images (still or moving) and/or my spoken words in perpetuity for educational, promotional and marketing purposes with prior advance notice.

By signing this Consent, I agree:
To allow the recording of your image and voice (e.g., photographs, audio, or video).
To distribute your image or recording in any medium, be it print or electronic form, which may include the Internet, including but not limited to, Facebook, Instagram, YouTube, Twitter, Threads).
To grant permission to other entities to reproduce the images or recording for educational, promotional or marketing purposes for the ISET program.

That there is no reimbursement for the right to take, or to use your photograph or video or recording.

My signature below denotes that I have read and understand that my consent, gives permission to NWAC and its sub-agreement holders to use my images, videos and audio as described above.

Client Signature(Required)

Authorization for Release of ISET Client Information(Required)

I, the undersigned, give my expressed and informed consent to the educational/training institute or my Employer (under a TWS or JCP), to release information to the Native Women’s Association of Canada and/or its sub-agreement holders to the Indigenous Skills and Employment Training Program (hereinafter referred to as ISET).

I understand that my consent and authorization is valid in perpetuity for all information related to the program, classes, attendance, or wage subsidy that are funded by Employment and Social Development Canada (ESDC) under the ISET program and delivered by NWAC and/or its sub-agreement holders.

I understand that it is my personal responsibility to inform the Registrar’s Office, my Employer and the NWAC and/or its sub-agreement holder in writing should I decide to withdraw my consent to release student information.

Under the Freedom of Information and Protection of Individual Privacy Act, I have the right to privacy of personal information held by government institutions, including institutions of learning.

My signature denotes my consent and authorization for the training/educational institution or Employer for which I received funding or wage subsidy through the ISET program to release personal information as described above to NWAC and/or its designate.

Client Signature(Required)

Confirm Details

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