I hereby understand that my personal information may be disclosed
to an authorized employee, agent or contractor of Alberta Human Services (HS) or Employment and Social Development Canada (ESDC)
to assist in determining my eligibility for programs and services; to monitor, assess and evaluate the effectiveness of services provided
and to evaluate the results of provincial programs.
I certify that I have read and understood all the instructions and information accompanying this registration form and that all statements
made in connection with this registration are true and complete in all respects. In addition I agree to the
This service is only available for residents of Alberta
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