Company Contact Information Employer Employer Name Employer Contact Person Employer Title Employer Address Street Address City Postal Code Employer Email Province/Territory Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Employer Phone Employer Fax Nominator (if different from above) Nominator Organization/Company Name Nominator Organization Contact Person Nominator Title Nominator Address Street Address City Postal Code Nominator Email Province/Territory Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Nominator Phone Nominator Fax General Information Number of employees in organization * Length of time organization has offered school-work programs * Sector * Arts & Culture Business & Entrepreneurship Construction Financial Services Health Sciences Hospitality & Tourism Information Technology Manufacturing Primary Industry (Agriculture, Forestry, Mining, Landscaping) Retail Other Program Information What kind of school-work programs has this employer provided for high school students? * Job Shadowing Mentoring Career Talks Classroom Visits School Work Transition Programs Ontario Youth Apprenticeship Program Cooperative Education Specialist High Skills Major Other check all that apply Please describe the types of school-work programs the employer provides, with an example of each if possible: How has the community benefited from this employer’s dedication to offering school-work programs to high school students? How has the employer benefited from offering high school students school-work programs? Describe the achievements of two students who have benefited from school-work programs with this employer. Please do not provide the students’ personal details. References Please provide two references who can talk about the nominated employer’s dedication to offering school-work programs to high school students. (Nominators can also act as a reference.) Reference #1 Reference First Name Reference Organization Reference Title Reference Last Name Reference Relationship to Employer Reference Address & Contact Info Street Address City Postal Code Email Province/Territory Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Phone Fax Reference #2 Reference First Name Reference Organization Reference Title Reference Last Name Reference Relationship to Employer Reference Address & Contact Info Street Address City Postal Code Email Province/Territory Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Phone Fax