Surrey Settlement Service Event Registration Form

Founded in 1973, S.U.C.C.E.S.S. is one of the largest social service agencies in Canada. S.U.C.C.E.S.S. offers a wide range of programs and services that promote the belonging, wellness, and independence of people in all stages of their Canadian journey. Please visit S.U.C.C.E.S.S. website www.successbc.ca for programs and services.
S.U.C.C.E.S.S. Settlement Program is funded by Immigration, Refugees and Citizenship Canada (IRCC) or the Ministry of Post-Secondary Education and Future Skills .

The Settlement Program acknowledges the privacy of its clients. Information provided for the program is confidential and retained in a secure and protected environment. To register for the group activity, please complete the online registration form below. Our staff will contact you prior to the program to verify your information and/or provide you with the link to join the group activity. The purpose of collecting your information is to better understand newcomers' needs and we use this information to better plan and manage our program and the services provided to you. This ensures that the support we provide is aligned with your needs.

Eligible participants: Permanent residents (economic immigrant eligibility limited to six years), protected persons, valid work/study permit holders, refugee claimants, naturalized citizens, CUAET, and BCPNP candidates.

Have you received services from S.U.C.C.E.S.S. Surrey before?

First Name
Last Name
Preferred Name
Gender
Date of Birth

YearMonthDay
Email
Phone
Format: (000) 000-0000.
Arrival Date

YearMonthDay
Date
Postal Code
Mother Tongue/ First Language
Country of Origin
Employment Status

Personal information collected and maintained by the S.U.C.C.E.S.S. Settlement & Family Services (including BCNSP and ISIP) is subject to the provisions of the applicable federal, provincial or territorial privacy and access to information legislation or the Personal Information Protection and Electronic Documents Act (PIPEDA) and the Personal Information Protection Act (PIPA). Therefore, information shared in-person, by phone, email, or online will be kept confidential in accordance with this legislation and will be used only to assist staff in providing service, determining service eligibility and generate anonymous statistics. Confidentiality of the information can only be breached when: required by law or by an order of court; there is reasonable ground to believe that such release will prevent harm; it is necessary to disclose the information to the personnel of S.U.C.C.E.S.S. or accreditation agencies that are authorized to receive such information in the course of their duties. All records are confidential and retained in a secure and protected environment. S.U.C.C.E.S.S. is required to record information pertaining to personal and service information on provincial or federal government department databases that monitor service outcomes.
Sharing information across service locations: If I access services (e.g., workshops, webinars, or activities) in another city where S.U.C.C.E.S.S. offers Settlement Programs, I consent to my information being shared with settlement staff in that location to support my service needs.
Receiving communications: I agree to be contacted by S.U.C.C.E.S.S. Settlement Program staff by phone, email, or online regarding services, workshops, courses, and events. I understand that I can withdraw my consent and unsubscribe from communications at any time.
Participation in future research: I agree to be contacted for voluntary research or evaluation related to settlement services conducted by third parties on behalf of the Government of Canada. I may decline or withdraw at any time.
Date

YearMonthDay
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