About
Programs
Advocacy
How to Help
Events
Donate

Step Ahead Application Form

Name *

First

Last

Date of Birth *

Phone Number *

Address *

Email *

Emergency Contact *

First

Last

Relationship *

Phone Number *

Can I leave a message with them? *

Income Assistance Worker Information *

First

Last

Phone *

Phone Extension

Single Line Text

The following questions are eligibility requirements. If you answer no for any of the questions, you will not be eligible for the program.

Choice 1

Are you a Canadian citizen, permanent resident, or person who has been granted refugee status in Canada? *

Are you a resident of the province of Nova Scotia? *

Are you out of school? *

Are you legally allowed to work in Canada? *

Are you able to commit to 24 hours a week of programming? *

Are you receiving income assistance? *

Currently working with Employment Support Services with the Department of Community Services? (Or recently been referred) *

* In order to qualify for the program, you must be eligible for Employment Support Services (ESS). If you are not currently working with an ESS worker, please request a referral from your Income Assistance (IA) Worker. You may require an updated medical form stating you are able to work to receive the referral.

Are you 19 years of age or older? *

Are you female, female identifying, or non-binary? *

The following questions are background information to determine what you need out of this program.

Choice 1

Have you completed high school? *

Do you have a disability? *

Do you have access to childcare? *

Yes
No
Not needed

Do you have any health concerns? *

Do you have (or have had) any difficulties with substance abuse? *

Do you have any language barriers? *

Do you have support from friends, family, and/or community members? *

Do you have a criminal record? *

Are you bondable? (i.e. Trustworthy and reliable) *

To be bondable means that your future employer is ensured and protected against any loss that comes as a direct result of fraudulent, dishonest, or criminal activities of an employee.

Why do you want to participate in the Step Ahead program? *

How will the Step Ahead Program help you achieve your goals? *

What do you expect to learn from participating in the Step Ahead Program? *

What are your interests? *

What are your strengths? *

What challenges would you like to address? *

The following questions are about your employment history. Jobs do not need to be recent.

Choice 1

Job One

Company

Position

Start Date

End Date

Duties

Job Two

Company

Position

Start Date

End Date

Duties

Job Three

Company

Position

Start Date

End Date

Duties

Collection, Use, & Disclosure of Personal Information: The Nova Scotia Government Labour Market Programs provided by the Departments of Labour and Advanced Education, Community Services, and the Office of Immigration, are bound by the principles and requirements of the Nova Scotia Freedom of Information and Protection of Privacy (FOIPOP) Act. The FOIPOP Act defines the meaning of personal information; in addition to the information defined by the Act, other types of personal information may include: date of birth, Internet Protocol address, e-mail address, or other information collected by our programs or services. The personal information collected will only be used and disclosed in keeping with the access and privacy provisions of the Nova Scotia FOIPOP Act and the Nova Scotia Personal Information International Disclosure Protection (PIIDPA) Act. Any personal information collected during the course of accessing our programs or using our services is used only for providing you with services; for example, for registration to our programs or for determining your eligibility to services etc. We do not disclose your personal information to other organizations or individuals except as required to fulfill the purpose(s) of the program or service and only to the extent required or authorized by law. Some functions within these programs or services are provided by service providers external to the department(s). All external service providers that provide you with services on our behalf must comply with our privacy requirements and must meet the applicable security, privacy and terms of use provisions. Under the privacy provisions of the FOIPOP Act individuals have the right to correction of, and access to, their personal information. To obtain access or request correction of your personal information please contact the Information Access and Privacy Services unit by email at IAPServices@novascotia.ca or phone (902) 424-2985 or 1-844-424-2985. *

I acknowledge that I have read and understand the above information regarding the collection, use, and disclosure of my personal information

I confirm that the information given in this form is true, complete, and accurate

Website

How can I help?

The YWCA Halifax relies on charitable donations and the generous support of our community. Because of you, we are building economic security, promoting wellness, and creating opportunities for young women, girls, two-spirit, gender diverse people and their families by providing a strong voice and integrated services.

Donate Now

Join us on social media

Featured Story

Palifax Summer Camp

Palifax (previously “Galifax”) is a fun summer camp that’s all about learning about yourself, how to express yourself creatively, advocate for your community, and share your voice! This year we’re excited to be partnering with the MacPhee Centre for Creative Learning to run this year’s camp.
Read More

Events
Our Voices
Careers
Contact
Board Members

YWCA Halifax
358 Herring Cove Rd.
Spryfield, NS
t: 902.423.6162

Registered Name: Young Women’s Christian Association of Halifax

Charity No: 108229881RR0001