COSTI Client Registration

COSTI

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Client Registration Form

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Required fields are marked in yellow.

Client

First Name
Last Name
Middle Name
User Name
Gender

Contact Information

City
Street
Apt./Unit No.
Postal Code
Please contact me by :: Either Phone or Email is required
Phone
Email

I don't have a permanent address OR address is temporary

Demographics

Date of Birth (dd/mm/yyyy)
Country of Birth
First Language
Level of Spoken English
Highest Education
NOC. Occupational / Professional Background

Contextual Help

Dynamic for every field

Referral Sources

Please tell us how you found out about COSTI by selecting from the options below:

COSTI Website	Transit Ads (bus or bus shelter)
COSTI Sign	Community Partner
Search Engine, such as Google	Community Event
Other Website	Friend/ Word of Mouth
Job Fair	Instagram
Newspaper	Twitter
Brochure/ flyer	Facebook
Hot Sign	Other
Billboard

Consent to Receive Email News and Communiques

Yes, I am interested in receiving emails from COSTI regarding the services I am receiving. I am also interested in receiving emails regarding:

Announcements about programs and services

Employment opportunities, jobs fairs

Employer hosted events

Fundraising Events

Workshops

Membership Campaigns, including Friends of COSTI

Newsletters

Languages Bureau

Summer English Language and Cultural Experience Program

Skills Training Courses including MS Office, Outlook, AccPac, Simply Accounting or any new course

No, I am not interested in receiving any emails from COSTI.

Consent for IRCC

I have read the Consent Statement for Immigration, Refugees & Citizenship Canada (IRCC). I hereby give consent for IRCC to contact me in the future for the sole purpose of asking questions relating to IRCC services provided to me by COSTI.

Consent for Disclosure of Personal Information

COSTI recognizes that information provided in the Client Registration Form is confidential and will not be released without my prior consent. I hereby give consent to COSTI to share the information I have provided herein to staff within COSTI for the sole purpose of providing services to me. I understand that COSTI will use aggregate statistical data from the Client Registration System for planning and presentation purposes.

I have read the statement and agree

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