La Relance

270 Des Allumettières Blvd.
Gatineau, Quebec J8X 1N3

Téléphone 819-770-6444
Bell 819-770-5328

Opening Hours

From Monday to Friday from 8 a.m.
to 5 p.m.

Program Registration Form

La Relance will respond to your registration request within two business days. The information you provide on this form will help us determine the best programs and services for you.

All personal information will be kept strictly confidential.

Required fields are marked with an asterisk.

*First name

*Last name

*Telephone

*Email

City of residence

Language
EnglishFrenchSpanishOther

Age
16 - 2930 or older

Residency status
Canadian citizenPermanent residentOther

Educational level
PrimarySecondaryCollegeUniversityOther

Current employment situation

Check all that apply.

I’m looking for a jobI have a full-time jobI have a part-time jobI’ve never had a jobI’m a studentOther

Functional limitations (disabilities) (if applicable)
NoneAuditory/visualIntellectualDegenerative diseasePhysical/motorMental healthOther

Source of income
Employment insurance (EI)WelfareNoneOtherPrefer not to answer

I’d like more information about the following programs or services

Job Finding ClubTechnical Work Experience Program (TWEP)Employment Integration ProgramSpecialized Service for People with DisabilitiesJob Finding Strategy

Where did you hear about La Relance?

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