If you are experiencing any difficulties completing this online form, please call us toll free at 1-866-550-0697.
*mandatory

Due to a problem with our database; if you leave a field marked with a red asterisk blank, then the form will not be submitted but you will be forwarded to our “About You” page regardless. In that case, we will not receive your registration. Please double-check all mandatory fields before submitting your information. We have notified our web developer and are working on this issue.

Personal Information
First Name* Last Name*
Preferred Name:
Date of Birth*

Please enter as: “DD/MM/YYYY” and remember to include the forward-slashes. Example: October 5, 1982 = 05/10/1982 – Thanks.
I identify as *

Status In Canada*

Marital Status*

Your Personal Email* Place of Birth (Country)
Street/P.O. Box/R.R.#* City*
Postal Code* Phone*
Education & Employment
Highest Level of Education Completed*

Employment Status*

Where did you go to school?*

Source of Income*

Has your education been interrupted by events in your life?* Yes No Employment Experience*

How long have you been out of school?*

If unemployed, how long have you been out of work?*

How long have you been out of training?*

Are you A Registered Apprentice?*

Yes No

Learning Details
Are you participating in a Literacy & Basic Skills program?*

Where will you be taking your classes?*

Who referred you to GLA?*

Were you referred by Employment Ontario Self Service?*

What is your goal path?*

Short term Goal (within a year)

Long term Goal (In the next 5 years)

Voluntary Self-Identification
Please select more than one answer if they apply. Collection of this information is for statistical purposes only so we can continue to offer online courses at no charge.
Person with Disability

Aboriginal Group

Visible Minority

Newcomer

Deaf

Francophone

Language
Preferred Language of Service*

Preferred Communication
Language Spoken at Home*

Language Spoken at Last Workplace

Notice of Collection & Consent

View Notice & Agreement

This is the Learner Consent Agreement.

If you agree with what is written below, please enter your First Name and Last Name at the bottom.

If you have any questions or concerns, please call us at 1-866-550-0697 or email us at info@goodlearninganywhere.com

Notice of Collection and Consent (Ministry of Training, Colleges & Universities)

The Ministry of Training, Colleges and Universities is the government organization that gives funding to Good Learning Anywhere so it can train learners like you under the e-Channel program, part of Employment Ontario (EO) programs and services.

The ministry has a funding agreement with Good Learning Anywhere.

In return for the government funding, Good Learning Anywhere, must give data with client and learner information to the ministry about the services it provides. The data will not contain your name or other identifier.

The data helps the ministry understand how Good Learning Anywhere uses the funding it gets from the ministry and will let the ministry know how well the program is doing.

In addition, Good Learning Anywhere, must let its operations be audited, inspected or investigated by the ministry or specialists it hires and, if this happens, the ministry or its specialists may need to see client and learner files as part of the audit, inspection or investigation.

The ministry that funds Good Learning Anywhere might also like to contact learners, such as yourself, to ask if they will voluntarily provide their opinion about the program, either individually or as part of a group.

In order to ask your permission, the ministry would need to get your phone number, address, or e-mail from Good Learning Anywhere so that someone could contact you.

You would be free to participate and you would also be free to say no.

When you sign this form by electronic or non-electronic means, you are giving the ministry your permission to collect and use your personal information for all the reasons stated above.

The Ministry collects and uses your personal information in accordance with s. 38(2) of the Freedom of Information and Protection of Privacy Act, which is the law that the government of Ontario must follow to ensure that your personal information is protected.

For more information about the collection and use of your personal information under the e-Channel program, you can contact the Manager, Employment Ontario Hotline, in writing at the Ministry of Training, Colleges and Universities, 33 Bloor Street East, 2nd Floor, Toronto, Ontario M7A 2S3 or by phone at 1-800-387-5656 or visit the website at:

http://www.tcu.gov.on.ca/eng/threeWays.html.

For service in a language other than English or French: After the telephone greeting please stay on the line and an information counsellor will assist you by adding a certified interpreter to the call to help us get you the information you need. TTY (telephone service for the deaf) is available at 1-866-533-6339.

Consent to Collect Information

Sioux-Hudson Literacy Council collects learner information to ensure the best delivery of programs. Your information helps us determine your needs, provide services and classes with you in mind, and helps to ensure funding commitments. Your information is protected by our privacy policy which adheres to FIPPA, MFIPPA and PIPEDA.

SHLC Privacy Policy Agreement

I have read the SHLC privacy policy, agree to the collection, understand why it is collected, that it is protected and that I have the right to see this information to make sure it is correct.

By entering your name and checking the box “I agree” below, you give consent to the Ministry and Sioux Hudson Literacy Council to indirectly collect, use and disclose your personal information for the purposes set out above.

Information Storage Notice

Collected information is stored as bits and bytes by the Zoho Corporation in their California and Texas server farms (http://www.zoho.com). Zoho maintains both a physical and digital security system that restricts access even to their own employees (see items # 5-6 http://www.zoho.com/zoho_faq.html).
* I agree to the Notice of Collection & Consent (Ministry of Training, Colleges & Universities)
Consent to Share Information Agreement (Optional)
Information about your learning can be shared with other people who you are working with (for example a teacher, caseworker, etc…)Is there anyone you want (or need) us to share information with? If so, fill in their name and email below:

Practitioner Name

Practitioner Email
This sharing of information may include:

  • Learner Plan
  • Registration Information
  • Attendance
  • Results of Assessments
I give my consent to share information:
Groups
Are you taking The First Step, Job Readiness or Post Secondary Program? Are you part of another group? If you are, please select from the drop-down menu.

NOTE: First Step is a prerequisite to the Job Readiness and Post Secondary Readiness groups.

Groups

First Step

Job Readiness

Post Secondary Readiness

Independent Learning
Essential Skills

Accucess

Pre-GED

Ready for College

Career Introduction/Other

Short Courses
(Hold Ctrl, or Command if on a Mac, for multiple selections)

Comments
By clicking on Submit I agree that all the information I am sending
within this form is accurate to the best of my knowledge.