Empowering Manitoba’s Youth
614 - 294 Portage Avenue
Winnipeg, MB R3C 0B9
204 – 987 – 8661
www.yesmb.ca

You MUST provide your SIN at your appointment, or you will not be able to meet with an Employment Facilitator. Please complete form in its entirety.

Visible Minority: this category includes persons who are non-Caucasian in race or non-white in color and who do not report being Indigenous.

Dependent is an individual who lives in the same household as the participant and for whom they have caregiving responsibilities. The dependent may be a child (by birth, marriage, adoption or be a foster child) or an adult dependent (e.g. an adult offspring with a disability.

614 - 294 Portage Avenue

Winnipeg, MB

R3C 0B9

Phone: 204.987.8661

Fax: 204.942.8262

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© 2020 - Y.E.S. Manitoba Inc.