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Login:^*Please choose a password
First name:^*
Last name:^*
Email:^*
Birth Date:^*
Gender:^*	male female
City:^*
Province:^*
Country:^*
If currently employed, how many hours per week?^*
Are you currently receiving EI benefits?^*	yes no
Have you received EI benefits within the last 3 years?^*	yes no
Have you had a Maternity / Parental claim within the last 5 years?^*	yes no
If you are a client of the Sunshine Coast Employment Centre, please enter your client # here:^* If you aren't a client please enter the number 0
Are you an employer?	yes no
Are you a jobseeker?	yes no
How did you hear about us?
Do you have a disability?	yes no
Are you a member of a visible minority group?	yes no
Are you Aboriginal?	yes no
Would you like to be contacted for further assistance? (If yes, phone # please)	yes no
Phone:

Registration information is not shared with any other agency or business. We require this information in order to provide stats as to the usefulness of our service to our clients, so that we may continue operating.

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