TSNN TEST FORM PAGE

Thank you for your interest in the Tourism SkillsNet North Program. For specific questions about the program, please forward them to Sara at communications@destinationnorthernontario.ca.
Registered/Corporate Information
Registered/Legal Name*
Corporate Business Name (hereinafter referred to as the "Employer")*
Canada Revenue Agency/Business Number*
Preferred Language*
- English
- French
Preferred Communication
- Phone
- Email
- Hard Copy

Is your corporate address the same as your mailing address?*
- yes
- no
If different, enter mailing address below.
Mailing Address (if different from Corporate Address)*
Street Address Address Line 2 City Province Postal Code

Alternate Corporate Contact Details
Do you have alternate corporate contact details?*
- yes
- no
If so, please enter below.
Last Name
First Name
Middle Initial
Title
Email
Phone
ext.
Fax Number
ext.

Are you receiving any other government funding associated with the employment/training of participants?*
- Yes
- No
If you selected 'yes' above, please specify here

Declaration and Consent
This certifies that the Employer:*
1. Is licensed to operate its business in Ontario;
2. Provides training in Ontario which is related to a job that is located in Ontario;
3. Complies with the Occupational Health and Safety Act and the Employment Standards Act;
4. Maintains appropriate Workplace Safety and Insurance Board or private workplace safety insurance coverage;
5. Has adequate third-party general liability insurance as advised by my insurance broker;
6. Complies with all applicable federal and provincial human rights legislation, regulations, and any other relevant standards;
7. Is not a federal, provincial or municipal government and/or agency;
8. If in receipt of other funds (government or otherwise) related to the same skills training for the same individual, funds must not exceed the total cost of wages paid to the participant; and
9. Will not use training participants to displace existing staff or replace staff who are on lay-off.
- I am authorized to act on behalf of the Employer and the information on this form is complete and accurate.
Providing false or misleading information in this form may result in the refusal of the application, or in the termination of any agreement entered into following approval of the application.
Name*
First Last
Title*
Date*
Month
Day
Year

Registered/Corporate Information