Trainee/Participation Completion

Q-STEP - Trainee Completion Form

Step 1 of 4

Personal Information / ᐃᕝᕕᑦ ᒥᔅᓵᓄᑦ ᑐᑭᓯᐅᒪᔾᔪᑎᔅᓴᑦ
All fields with * are required / ᑎᑎᖅᓯᒪᔪᓕᒫᑦ ᐅᓪᓗᕆᐊᕐᖑᐊᓕᖕᒥ * ᑕᑕᑎᖅᑕᐅᒋᐊᖃᖅᑐᑦ
Please enter your name / ᐊᑏᑦ ᑎᑎᕋᙳᐊᑕᕐᓯᓐᓇᕈᒃ*
First Name / ᐊᑏᑦ Last Name / ᐊᑎᕈᓰᑦ
Date of Birth / ᑎᑎᕐᓯᕕᒋᓗᒍ ᐅᑭᐅᑎᑦ ᓇᓛᓃᕝᕕᖏᑦ
Day / ᐅᓪᓗᖅ*
Month / ᑕᖅᑭᖅ*
Year / ᐊᕐᕌᒍ*
Select your community / ᓂᕈᐊᕆᑦ ᓄᓇᖃᕐᕕᓐᓂᒃ*
Mailing Address / ᑎᑎᖅᑲᓂᐊᕐᕕᒃᑯᑦ ᑐᕌᕈᑖ*
PO Box / ᑎᑎᖅᑲᓂᐊᕐᕕᒃᑯᑦ ᑐᕌᕈᑖ Community / ᓄᓇᓕᒃ Province / ᓄᓇᓕᐅᑉ ᐊᕕᒃᑐᖅᓯᒪᓂᕆᔭᖓ Postal Code / ᑎᑎᖅᑲᓂᐊᕐᕕᒃᑯᑦ ᓇᓗᓇᐃᒃᑯᑕᖓ
Phone / ᐅᖄᓚᐅᑖ*
Email / ᐃᕐᖐᓈᖅᑕᐅᑖ*
NTI number / ᓄᓇᕗᑦ ᑐᙵᕕᒃᑯᓐᓂᑦ ᐃᓚᒋᔭᐅᔾᔪᑏᑦ ᓈᓴᐅᑖ*
Do not include dashes or spaces with your NTI number / ᐱᖃᓯᐅᔾᔨᑦᑕᐃᓕᒋᑦ ᑎᑎᖅᓯᒪᔪᓂᑦ ᓈᓴᐅᑎᐅᙱᑦᑐᓂᑦ ᐊᒻᒪᓗ ᑲᑎᙵᑎᑦᑕᐃᓐᓇᕆᓗᒋᑦ ᓄᓇᕗᑦ ᑐᙵᕕᒃ ᑎᒥᖓᓄᑦ ᓈᓴᐅᑎᕆᔭᑎᑦ
SIN Number / ᐃᖅᑲᓇᐃᔭᖅᑐᕐᓯᐅᑦ ᓈᓴᐅᑏᑦ*

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Training Information / ᐱᓕᒻᒪᒃᓴᕈᑏᑦ ᑐᑭᓯᒋᐊᕈᑎᖏᑦ
All fields with * are required / ᑎᑎᖅᓯᒪᔪᓕᒫᑦ ᐅᓪᓗᕆᐊᕐᖑᐊᓕᖕᒥ * ᑕᑕᑎᖅᑕᐅᒋᐊᖃᖅᑐᑦ
Name of Course/Training / ᐃᓕᓐᓂᐊᒐᒃᓴᑉ / ᐱᓕᕆᐊᑉ ᐊᑎᖓ*
Name of Training Institution or Employer / ᐊᑎᖓ ᐃᖅᑲᓇᐃᔭᕐᕕᑉ ᐅᕝᕙᓘᓐᓃᑦ ᐱᓕᒻᒪᒃᓴᐃᓂᕐᒧᑦ ᐃᓕᓐᓂᐊᕐᕕᒃ*
Did you complete the training/course for this fiscal year? / ᑖᓐᓇ ᐱᔭᕇᕐᓂᖅᐱᐅᒃ ᐱᓕᒻᒪᒃᓴᖅᑕᐃᑦ/ᐃᓕᓐᓂᐊᖅᑕᐃᑦ ᑕᒫᓂ ᑮᓇᐅᔭᓕᕆᓐᓇᑉ ᐊᕐᕌᒍᐊᓂ?*
- Yes / ᐄ
- No / ᐋᒡᒐ
Start date of training / ᐅᓪᓗᖅ ᐱᒋᐊᕐᕕᒥᓃᑦ ᐱᓕᒻᒪᒃᓴᕐᓗᑎᑦ
Day / ᐅᓪᓗᖅ*
Month / ᑕᖅᑭᖅ*
Year / ᐊᕐᕌᒍ*
Actual finish date / ᐱᔭᕇᖅᑕᒥᓃᑦ ᐅᓪᓗᓪᓚᑦᑖᖓ
Day / ᐅᓪᓗᖅ*
Month / ᑕᖅᑭᖅ*
Year / ᐊᕐᕌᒍ*
If not completed, please provide the reason(s) / ᐱᔭᕇᕐᓂᙱᒃᑯᕕᐅᒃ ᐃᓕᓐᓂᐊᕋᒃᓴᖅ, ᑎᑎᕋᕐᓗᑎᑦ ᐱᔾᔪᑎᖏᖕᓂᑦ ᐱᔭᕇᙲᓐᓇᖅᑕᒥᓂᕆᓪᓗᒍ*
Did you receive childcare while attending training? / ᐸᐃᕆᕕᒻᒦᑎᑦᑎᔭᕆᐊᖃᕐᓂᖅᐲᑦ ᕿᑐᕐᖓᖕᓂᑦ ᐱᓕᒻᒪᒃᓴᖅᑎᓪᓗᑎᑦ?*
- Yes / ᐄ
- No / ᐋᒡᒐ
Who funded the childcare? / ᑭᐊᑉ ᑮᓇᐅᔭᖃᖅᑎᓐᓂᖅᐹ ᐸᐃᕆᔨ?*
What were the total costs? / ᖃᑦᑎᐅᓐᓂᖅᐸᑦ ᐊᑭᖏᑦ ᑲᑎᓕᒫᖅᑐᒋᑦ?*

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Declaration and authorization to release information / ᓇᓗᓇᐃᖅᓯᔾᔪᑎ ᐊᒻᒪᓗ ᐱᔪᓐᓇᐅᑎᑦᑎᔾᔪᑎ ᓴᒃᑯᑕᐅᖁᓪᓗᒋᑦ ᑐᑭᓯᒋᐊᕈᑏᑦ
All fields with * are required / ᑎᑎᖅᓯᒪᔪᓕᒫᑦ ᐅᓪᓗᕆᐊᕐᖑᐊᓕᖕᒥ * ᑕᑕᑎᖅᑕᐅᒋᐊᖃᖅᑐᑦ
By checking this box I acknowledge that I give my consent for Qikiqtani Inuit Association to release the information contained in this form regarding my participation in an SPF program to ESDC/Service Canada and Qikiqtani Inuit Association. I acknowledge that the information is collected and administered in accordance with the Privacy Act and applicable to privacy laws, and that it may be used to determine my eligibility for the SPF program and provided to ESDC/Service Canada for the evaluation and accountability of the SPF program. / ᑭᑉᐹᕆᑦᑐᒧᑦ ᑎᑎᖅᓯᓪᓗᖓ ᐃᓕᓴᖅᓯᕗᖓ ᐊᒻᒪᓗ ᐊᖏᖅᑐᒋᑦ ᕿᑭᖅᑕᓂ ᐃᓄᐃᑦ ᑲᑐᔾᔨᖃᑎᒌᒃᑯᖏᖕᓂᑦ ᓴᒃᑯᐃᓗᑎᑦ ᑐᑭᓯᒋᐊᕈᑎᓂᑦ ᑕᒡᕙᓃᑦᑐᓂᑦ ᓈᑎᕆᐊᓕᒻᒥ ᐃᓚᐅᖃᑕᐅᓂᒃᓴᓐᓄᑦ SPF ᐱᓕᕆᐊᖓᓂᒃ ᑖᒃᑯᓄᖓ ᐃᖅᑲᓇᐃᔭᖅᑐᓕᕆᓂᕐᒧᑦ/ᐱᔨᑦᑎᕋᖅᑏᑦ ᑲᓇᑕᒥᒃᑯᓐᓄᑦ, ᕿᑭᖅᑕᓂ ᐃᓄᐃᑦ ᑲᑐᔾᔨᖃᑎᒌᖏᖕᓄᑦ, ᐊᒻᒪᓗ ᑲᑭᕙᒃ ᑲᑐᔾᔨᖃᑎᒌᖏᖕᓄᑦ. ᐃᓕᓴᖅᓯᕗᖓ ᑕᒪᒃᑯᐊ ᑐᑭᓯᒋᐊᕈᑏᑦ ᓄᐊᑕᐅᓯᒪᔪᑦ ᐊᒻᒪᓗ ᐊᐅᓚᑕᐅᒻᒪᑕ ᒪᓕᑦᑐᒋᑦ ᑲᙳᓇᖅᑐᒦᑎᑦᑎᔭᕆᐊᖃᕐᓂᕐᒧᑦ ᐱᖁᔭᕐᒥᒃ ᐊᒻᒪᓗ ᐊᑐᖅᑕᐅᔭᕆᐊᓖᑦ ᑲᙳᓇᖅᑐᓕᕆᓂᕐᒧᑦ ᐱᖁᔭᕐᓂᑦ, ᐊᒻᒪᓗ ᐊᑐᖅᑕᐅᔪᓐᓇᕋᖅᑐᓂ ᓇᓗᓇᐃᖅᑕᐅᖁᓪᓗᒍ ᐱᔪᓐᓇᕐᓂᕋ SPF ᐱᓕᕆᐊᖓᓄᑦ ᐊᒻᒪᓗ ᑐᓂᔭᐅᓗᑎᑦ ᐃᖅᑲᓇᐃᔭᖅᑐᓕᕆᓂᕐᒧᑦ/ᐱᔨᑦᑎᕋᖅᑏᑦ ᑲᓇᑕᒥᒃᑯᓐᓄᑦ ᖃᐅᔨᓴᖅᑕᐅᖁᓪᓗᒍ ᐊᒻᒪᓗ ᓵᑕᐅᓯᒪᔪᓐᓇᖁᓪᓗᒍ SPF ᐱᓕᕆᐊᖓ.*
- I agree
Please enter your name / ᐊᑏᑦ ᑎᑎᕋᙳᐊᑕᕐᓯᓐᓇᕈᒃ*
First Name / ᐊᑏᑦ Last Name / ᐊᑎᕈᓰᑦ
Email
This field is for validation purposes and should be left unchanged.

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86763

Trainee/Participation Completion

Q-STEP - Trainee Completion Form

Step 1 of 4

Personal Information / ᐃᕝᕕᑦ ᒥᔅᓵᓄᑦ ᑐᑭᓯᐅᒪᔾᔪᑎᔅᓴᑦ

Training Information / ᐱᓕᒻᒪᒃᓴᕈᑏᑦ ᑐᑭᓯᒋᐊᕈᑎᖏᑦ

Status After Training / ᑭᓱᓕᕆᓚᐅᕐᓃᑦ ᐱᓕᒻᒪᒃᓴᕇᖅᑎᓪᓗᑎᑦ

Declaration and authorization to release information / ᓇᓗᓇᐃᖅᓯᔾᔪᑎ ᐊᒻᒪᓗ ᐱᔪᓐᓇᐅᑎᑦᑎᔾᔪᑎ ᓴᒃᑯᑕᐅᖁᓪᓗᒋᑦ ᑐᑭᓯᒋᐊᕈᑏᑦ