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English Language Learning: Service Registration Form
Which Branch
(Required)
-- Please Select --
Halifax Central Library
Alderney Gate Public Library
Bedford Public Library
Captain William Spry Public Library
Halifax North Memorial Public Library
Keshen Goodman Public Library
Sackville Public Library
Woodlawn Public Library
Virtual Sessions
Section 1: Personal Information
Name
(Required)
First
Middle
Last
Phone
(Required)
Email
(Required)
Birth Date
(Required)
DD slash MM slash YYYY
Marital Status (Optional)
Single
Married
Common-Law
Separated
Divorced
Widowed
Other
Gender Identity (Optional)
Woman
Man
Non-binary
Other
Preferred Service Language
(Required)
English
French
Section 2: Mailing Address
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Section 3: Settlement Information
Country of Birth
(Required)
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Native Language
(Required)
Number of Dependents
(Required)
A dependent is someone who relies on another person for financial support, such as food, housing, or clothing.
Section 4: Self-Identification
Self-Identification (Optional)
Aboriginal / Indigenous
Immigrant
Person with a Disability
Member of a Visible Minority
What year did you immigrate to Canada?
Section 5: Immigration Category
Immigration Category
(Required)
Atlantic Immigration Program Dependent
Atlantic Immigration Program PA
Atlantic Immigration Program PA Intermediate-Skilled
Atlantic Immigration Program PA High-Skilled
Atlantic Immigration Program PA International Graduate
Canada-Ukraine Authorization for Emergency Travel (CUAET)
Permanent Residents of Canada
Nova Scotia Nominees
Protected Persons (section 95 of IRPA)
Asylum Seeker
Canadian Citizens born outside Canada
Individuals awaiting statutory IRCC Checks
Immigr-Nova Scotia Nominee - Dependent
PR-Nova Scotia Nominees
PR Applicants with Work Permit
PR-Refugees
Section 6: Employment & Education
Highest Level of Education Completed
(Required)
Less than Grade 6 Complete
Less than Grade 9 Complete
Less than Grade 11 Complete
Completed Grade 11
Some Grade 12
High School Diploma
High School Equivalent
Non-University Incomplete
Non-University Certificate / Diploma
University Incomplete
University Certificate / Diploma
University Degree
Master's Degree
Trade/Apprenticeship Complete
PhD (Doctorate)
Other
Employment Status
(Required)
Employed
Self Employed
Unemployed
Not in the Labour Force
Section 7: Consent & Signatures
Consent
(Required)
I acknowledge that I have read and understand the following information regarding the collection, use and disclosure of my personal information.
The Nova Scotia Government Labour Market Programs provided by the Departments of Labour, Skills and Immigration, Opportunities and Social Development, and the Office of Immigration, are bound by the principles and requirements of the Nova Scotia Freedom of Information and Protection of Privacy (FOIPOP) Act. The FOIPOP Act defines the meaning of personal information; in addition to the information defined by the Act, other types of personal information may include date of birth, Internet Protocol address, e-mail address, or other information collected by our programs or services.
The personal information collected will only be used and disclosed in keeping with the access and privacy provisions of the Nova Scotia FOIPOP Act and the Nova Scotia Personal Information International Disclosure Protection (PIIDPA) Act. Any personal information collected during the course of accessing our programs or using our services is used only for providing you with services; for example, for registration to our programs or for determining your eligibility to services etc.
We do not disclose your personal information to other organizations or individuals except as required to fulfill the purpose(s) of the program or service and only to the extent required or authorized by law.
Some functions within these programs or services are provided by service providers external to the department(s). All external service providers that provide you with services on our behalf must comply with our privacy requirements and must meet the applicable security, privacy and terms of use provisions.
Under the privacy provisions of the FOIPOP Act individuals have the right to correction of, and access to, their personal information. To obtain access or request correction of your personal information please contact the Information Access and Privacy Services unit by email at IAPServices@novascotia.ca or phone (902) 424-2985 or 1-844-424-2985.