Benoit First Nation

805 Oceanview Drive, De Grau, NL. A0N 1T1

BENOIT FIRST NATION

MEMBER SKILLS INVENTORY

QUESTIONNAIRE

Please note:

a) The information contained in this questionnaire will be used primarily by the Employment and Training Committee.

b) If you need assistance completing the questionnaire, please contact us.

c) When you have completed the questionnaire please return it to the Band council.

Personal Information:

Full Name:

(Surname) (First Name) (Initial)

Mailing Address:

Home Telephone Number: ______

Languages Spoken: ______

Written: ______

EMPLOYMENT RELATED INFORMATION

Your Employment History:

YEAR
(From – to) / POSITION
HELD / BRIEF DESCRIPTION OF
DUTIES & JOB SKILLS

Please indicate the type of work you will be seeking, in order of preference:

a) ______

b) ______

c) ______

d) ______

Other related work skills and experience (include marketable skills from outside

interests and hobbies):

a) ______

b) ______

c) ______

d) ______

3. EDUCATION AND TRAINING

Please list the most recent educational institution attended and from which you

graduated. This includes high school, trade school, and technical institute college

and university:

Name of School: ______

Location: ______

Degree or Diploma: ______

Do you have any Trades Qualification? Yes / No

If yes, please list ______

Type and date of

Certification: ______

Do you hold an Apprenticeship or Trades Qualification in another Province or

Country?

Yes / No

If yes, please list: ______

Please check or list all related tickets and certificates held:

WHMIS ______LEVEL ______

TDG ______LEVEL ______

FIRST AID ______LEVEL ______

CPR ______LEVEL ______

FIRE / RESCUE ______LEVEL ______

OTHER ______LEVEL ______

Please list any other special courses which you have taken:

Course Name School Year

a) ______

b) ______

c) ______

d) ______

e) ______

f) ______

List other work related skills:

a) ______

b) ______

c) ______

Do you have a valid NL Drivers License? Yes / No Class ______

OTHER INFORMATION

Are you interested in more information about or assistance with the following?

YES NO

a) Resume Writing ______

b) Interview Training ______

c) Job Search training ______

d) Retraining or skills upgrade ______

e) Examining job options ______

f) Self-employment ______

g) How to start your own business ______

h) Personal counseling – indicate type ______

i) Financial planning ______

j) Other ______

If Yes to retraining or skills upgrade, please explain: ______

______

If yes to other, please explain: ______

______

Thank you for taking the time to complete this form. Please return it to the

Band Council.

Contact Information:

Chief Jasen Sylvester Benwah...... 709-644-2330 wikuom

Vice Chief Peter A. Benoit...... 709-785-5535 wikuom

Secretary Glenda Benwah...... 709-643-9113 wikuom

Treasurer Conrad Benoit...... 709-643-3840 wikuom

Elders Director Jerome Benoit...... 709-644- 2453 wikuom

Women’s Director Mary Phyllis Young...... 709-644-2425 wikuom

Youth Director Samantha L. Jesso...... 709-643- 2108 wikuom

Band Office telephone: 709-644-2688