Rural Renewal Stream Employer Application Form

Section 1: Business Information

Section 1A: Consultant Information

Section 2: Business Contact Information

Section 3: Immigration Program Questionnaire - Regulatory

*Failure to provide sufficient detail will result in the your application being rejected

Section 3A: Immigration Program Questionnaire - Other

Section 4: Position Details

Section 5: Statement of Applicant

I solemnly declare all information provided is true, accurate, complete, and that the employer:

• Is located within the municipal boundaries of the City of Cold Lake.
• Has considered Canadians and Permanent Residents for the subject job.
• Is offering a job which is full-time (minimum 30 hours per week), non-seasonal and permanent (12 months or more).
• Is offering a job which meets or exceeds the lowest starting wage for the occupation across all industries in Alberta as set out in the Alis Website.
• Confirms that the majority of the job duties will be performed within the City of Cold Lake.
• Is not known to be in violation of any federal, provincial or municipal legislation, bylaws or regulations.
• Agrees to abide by the rules and guidelines of the City of Cold Lake Rural Renewal Stream Program Partnership.
• Has reviewed and will comply with eligibility requirements under the Alberta Advantage Rural Renewal Stream.
• Will review and confirm eligibility requirements with any prospective candidates prior to issuing an offer of employment, including admissibility requirements under the Immigration and Refugee Protection Act and its Regulations.
• Understands that misrepresentation could result in disqualification from the program.
• Does Herby WAIVE, RELEASE and FOREVER DISCHARGE the City of Cold Lake, their agents, employees, volunteers, successors, and assigns any and all persons, firms, or corporations liable or who might be claimed to be liable, whether or not herein named (the “Releasees”), from all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage or injury that may be sustained while participating in the City of Cold Lake Rural Renewal Stream Community Partnership and the Alberta Advantage Rural Renewal Program (collectively “Programs”), or while employing anyone in relation to the Programs, regardless of whether such loss or damage is caused by the negligence of the Releasees, or otherwise, and regardless of whether such liability arises in tort, contract, strict liability, or otherwise, to the fullest extent allowed by law. It is my express intent that this General Liability Release shall bind the members of my family, spouse, my heirs, assigns any personal representative, and shall be deemed as a RELEASE, DISCHARGE, and COVENANT NOT TO SUE the above named Releasees as stated above. In signing this Application, I acknowledge and represent that I have read the foregoing General Liability Release and Indemnity agreement, understand it and sign it voluntarily as my own free act and deed; no representations, statements or inducement has been made; I am at least eighteen (18) years of age and fully competent; and I execute this Application for full, adequate and complete consideration fully intending to be bound by same.

Information on this form is collected for the sole use of the City of Cold Lake and is protected under the authority of the Freedom of Information and Protection of Privacy Act, Sec. 33 (c), which regulates the collection, use, and disclosure of personal information. If you have any questions or concerns, please contact the FOIP Coordinator by email (legislative@coldlake.com) or phone (780) 594-4494 ext. 7915.

5513 48 Avenue, Cold Lake, AB • T9M 1A1 • Ph: 780-594-4494 • Fax: 780-594-3480