Employee Information Sheet

PLEASE SUBMIT BEFORE OCTOBER 21, 2011

Personal Information
Identification - Equal Access to Employment
GENDER:
Aboriginal Peoples: For the purpose of the Act, Aboriginal people are Indians, Inuit or Métis of Canada.
Do you belong to the Aboriginal peoples of Canada?

Visible Minorities: Blacks (Africans, Haitians, Jamaicans, etc) South Asians (Bengalis, Tamils, Indians of India etc) Chinese (from Hong Kong, China, Mongolia, etc) Koreans, Japanese, Southeast Asians (Vietnamese, Cambodians, Thais, Laotians, etc) Filipinos, Other Pacific Islanders, West Asians & Arabs (Armenians, Iranians, Lebanese, Moroccans, Egyptians, Turks, etc) Latin Americans (Brazilians, Colombians, Cubans, Peruvians, Guatemalans, etc)

Do you belong to a visible minority?

Ethnic Minorities: Members of ethnic minorities are persons, other than Aboriginal people and members of visible minorities, whose mother tongue is neither French nor English. Mother Tongue is the language that you first learned in your childhood and still understand to belong to an ethnic minority. In addition that language may not be French or English. (Examples, German, Bulgarian, Spanish, Greek, Hungarian, Italian, Polish, Portuguese, Romanian, Russian, Ukrainian, etc).

Do you belong to an Ethnic minority?

Handicapped Persons:  A handicapped person is a person,   

  • with a deficiency (the loss, malformation or insufficiency of an organ or bodily structure, present from birth or that occurs during the person’s lifetime)
  • causing a significant (of a degree of severity or gravity that makes it impossible to restore the person’s capacities through the use of prostheses such as glasses, contact lenses  or hearing aids, or ortheses such as orthopaedic inserts or shoes) –and persistent (not expected to disappear)
  • disability (a reduced ability to function in intellectual, psychological, psychological, physiological or anatomical terms in a way or within limits considered to be normal)
  • who is liable to encounter barriers in performing everyday activities.
  • inability to speak or difficulty speaking and being understood;
In light of the above are you a handicapped person?
SYSPER Information
Highest degree completed:
University
Great West Life Information
Please complete the following for updating in your GWL file:
Spouse
Dependents
1.
2.
3.
4.
Beneficiaries for Life Insurance only
1.
2.
3.
4.

Please don’t hesitate to contact humanresources@ubishops.ca if you require any assistance or need additional information for this questionnaire. Thank you for your cooperation.