Learner Application Form - 05-2025

I am over 18. *

Yes

I live in the province of Ontario *

Yes
No

Immigration Status *

Permanent Resident of Canada
Convention Refugee
Other

If you chose "Other immigration status" please specify: *

I did my CLB test *

Yes
No

My CLB level is:

Name *

First

Last

Gender Identity *

Female
Male
Prefer not to answer or Other

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Phone *

Name and Phone number of English-speaking contact (if applicable)

Country of origin *

First language *

I heard about ELTOC through: *

I agree to give English Language Tutoring for the Ottawa Community (ELTOC) consent to report my participation in their small group program to Immigration, Refugees and Citizenship Canada for reporting purposes. *

Yes
No