CANWiN Candidate Referral Form Survey

About Open Door Group & CANWiN:

Open Door Group is a CARF-accredited, not-for-profit organization that has worked collaboratively with funders, service partners, job seekers, and employers, to support inclusive hiring practices and remove barriers to employment since 1976. The CAN WiN program operated by Open Door Group helps employers meet workforce needs by connecting job seekers with disabilities to accessible employers across British Columbia, Alberta, Saskatchewan, Manitoba, and Ontario.

Important Notes for Referring Service Provider (the Referrer)

Before completing the Candidate Referral Form, please ensure that your candidate has read and signed the Candidate Consent Form. To complete the Candidate Referral Form, be sure to upload the candidate's signed consent form and resume at the bottom of this page.

Please fill in the information below to refer a candidate to the CANWIN program. Fields marked with * are required. If you need assistance to complete this form, please contact info@canadianpartnerswin.ca.

CANWiN Candidate Referral Form

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* 1. Referring Service Provider Name:

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* 2. Referring Service Provider Representative Name:

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* 3. Referring Service Provider Representative Email:

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* 4. Province:

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* 5. Candidate Name:

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* 6. Candidate Email:

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* 7. Candidate Phone Number:

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* 8. Candidate Preferred Method of Communication:

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* 9. Is the Candidate Eligible for CANWIN Services?: (To be eligible, the candidate must self-identify as a person with a disability and be legally entitled to work in Canada.)

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* 10. Has the Candidate been Convicted of a Criminal Offence for Which a Pardon has not been Granted? (Answer only if required by the job posting.)

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* 11. Employer and Position of Interest: (List the employer and the positions the candidate is interested in.)

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* 12. Candidate Shift Availability (Please select at least one shift or all the shifts that your candidate prefers to work.

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* 13. Candidate’s Strengths in Relation to the Position:

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* 14. Please List any Adjustments Needed in the Workplace for Employment Success: (What should the employer know to support the candidate on the job?)

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* 15. Additional Comments or Recommendations:

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* 16. Upload Candidate’s Consent Form Here:

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* 17. Upload Candidate's Resume Here:

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* 18. Referrer Acknowledgement: By checking the box below, the referrer acknowledges that this form was completed with the candidate’s agreement, in accordance with the candidate consent form, and that the information provided has not been altered without the candidate’s consent.