Computer Training

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Personal Information

SIN Number *

In order to participate in one-on-one online training, you must provide your Social Insurance Number (SIN). You may give your SIN to your WorkingNB employment counselor or Social Development Case manager OR you may give your SIN to the instructor when you join the one-on-one session.

Do you agree to provide your SIN?

 Yes Required field.

Learner Name * Required field.

Gender * Choose one --- Male (M) Female (F) Non-binary (X) Prefer not to disclose Required field. You must choose one.

Date of Birth

Day * Choose one --- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Required field. You must choose one.

Month * Choose one --- January February March April May June July August September October November December Required field. You must choose one.

Year * Required field. Please enter your four-digit year of birth (e.g. 1995).

Language Spoken * Choose one --- English French English and French Not a Federal Official Language Required field. You must choose one.

Language of Training * Choose one --- English French Required field. You must choose one.

Person with a Disability *  No
 Yes - Learning
 Yes - Hearing
 Yes - Intellectual
 Yes - Vision
 Yes - Mobility
 Yes - Other
Required field. You must choose at least one.

Contact Information

Address 1 * Required field.

Address 2

City/Town * Required field.

Province * Choose one --- New Brunswick Nova Scotia Prince Edward Island Newfoundland and Labrador Alberta British Columbia Manitoba Northwest Territories Nunavut Ontario Quebec Saskatchewan Yukon Required field. You must choose one.

Postal Code * Required field. Please use the following format: XXX XXX

Email * Required field. Please enter a valid email address.

Phone Number *

Please use the following format: ### ###-####

Required field. Please use the following format: ### ###-####

Additional Information

Computer Skills *

Which computer skill would you like your session to be about? Choose up to two (2) skills.

 Basics
 File/Folder Management
 Working Remotely
 Email
 Internet
 Word
 PowerPoint
 Excel
Required field. You must choose at least one.

Labour Force Attachment *

Are you currently employed or unemployed?

Choose one --- Employed Unemployed Required field. You must choose one.

Delivery Stream *

Why are you participating in this training session?

Choose one --- To gain skills that will help me to find a job It is part of a training at my current place of work Required field. You must choose one.

Referral Agency *

Did someone instruct you to sign-up for this program?

Choose one --- No Yes - Employment Counsellor Yes - Worksafe NB Yes - Social Development Yes - Employer Yes - Union Yes - Other Required field. You must choose one.

Education Level *

What level of Education have you completed?

Choose one --- High School Incomplete High School or GED Post Secondary Incomplete College, CEGEP or other non university certificate or diplomat University certificate or diplomat University degree Required field. You must choose one.

Last Grade Completed *

What is the last grade that you completed in school?

Choose one --- 1211 109 87 6 and under Required field. You must choose one.

Career Goal *

What is your career goal?

Choose one --- Employment Further Education GED Personal Required field. You must choose one.

Client Consent

Client Consent *

I have read the client consent form and I certify that the information I provided is accurate to my knowledge.

View Client Consent Form

 Yes, I agree. Required field.

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