Intake Form (์ ‘์ˆ˜ ์–‘์‹)

Client Intake Form Korean (์ ‘์ˆ˜ ์–‘์‹)

Instructions (์ง€์นจ)

All information entered must be in ENGLISH
๋ชจ๋“  ์ •๋ณด๋Š” ์˜์–ด๋กœ ์ œ์ถœํ•ด ์ฃผ์„ธ์š”

Address (์ฃผ์†Œ)
City (๋„์‹œ)
Province (์ฃผ)
Postal Code (์šฐํŽธ๋ฒˆํ˜ธ)
Gender (์„ฑ๋ณ„)
Official Language of Preference: (์„ ํ˜ธํ•˜๋Š” ๊ณต์‹ ์–ธ์–ด)
Immigration Status: (Choose one) (์ด๋ฏผ ์‹ ๋ถ„, ํ•˜๋‚˜๋งŒ ์„ ํƒํ•˜์„ธ์š”)
Immigration Class (์ด๋ฏผ ํด๋ผ์Šค)
Level of education: (Choose one) (๊ต์œก ์ˆ˜์ค€, ํ•˜๋‚˜๋งŒ ์„ ํƒํ•˜์„ธ์š”)

Family Members in Canada (Spouse, Children) (์บ๋‚˜๋‹ค ๊ฑฐ์ฃผํ•˜๋Š” ๊ฐ€์กฑ, ๋ฐฐ์šฐ์ž, ์ž๋…€๋“ค)

Confidentiality Statement

Kamloops Immigrant Services protects personal information by following the governmentโ€™s privacy laws as outlined in the Personal Information Protection Act, Bill 38: http://www.leg.bc.ca/37th4th/3rd_read/gov38-3.htm Personal Information provided to Kamloops-Cariboo Regional Immigrants Society (KCRIS) is used to meet clientโ€™s needs, statistics, evaluation of service and research by the federal/provincial government. Staff will not disclose any information without client permission unless legally obligated to do so. Completion and submission of this intake form implies consent to collecting information for these purposes.
I certify that all of the information provided herein is true and complete to the best of my knowledge. I understand that any misstatement, falsification or omission is grounds for termination of service.

๊ธฐ๋ฐ€ ์œ ์ง€ ์„ ์–ธ๋ฌธ

์บ ๋ฃน์Šค ์ด์ฃผ๋ฏผ ์„œ๋น„์Šค๋Š” ๊ฐœ์ธ์ •๋ณด ๋ณดํ˜ธ๋ฒ•, ๋ฒ•์•ˆ 38์— ๋ช…์‹œ๋œ ๋ฐ”์™€ ๊ฐ™์ด ์ •๋ถ€์˜ ๊ฐœ์ธ ์ •๋ณด ๋ณดํ˜ธ๋ฒ•์„ ์ค€์ˆ˜ํ•˜์—ฌ ๊ฐœ์ธ ์ •๋ณด๋ฅผ ๋ณดํ˜ธํ•ฉ๋‹ˆ๋‹ค. http://www.leg.bc.ca/37th4th/3rd_read/gov38-3.htm ์บ ๋ฃน์Šค ์บ๋ฆฌ๋ถ€ ์ง€์—ญ ์ด์ฃผ๋ฏผ ํ˜‘ํšŒ์— ์ œ๊ณต๋˜๋Š” ๊ฐœ์ธ ์ •๋ณด๋Š” ๊ณ ๊ฐ์˜ ์š”๊ตฌ, ํ†ต๊ณ„ ์„œ๋น„์Šค ํ‰๊ฐ€ ๋ฐ ์—ฐ๋ฐฉ/์ง€๋ฐฉ ์ •๋ถ€์˜ ์—ฐ๊ตฌ๋ฅผ ์ถฉ์กฑํ•˜๋Š”๋ฐ ์‚ฌ์šฉ ๋ฉ๋‹ˆ๋‹ค. ์ง์›์€ ๋ฒ•์  ์˜๋ฌด๊ฐ€ ์—†๋Š” ํ•œ ๊ณ ๊ฐ์˜ ํ—ˆ๊ฐ€ ์—†์ด ์ •๋ณด๋ฅผ ๊ณต๊ฐœํ•˜์ง€ ์•Š์Šต๋‹ˆ๋‹ค. ์ด ์ ‘์ˆ˜ ์–‘์‹์˜ ์ž‘์„ฑ ๋ฐ ์ œ์ถœ์€ ์ด๋Ÿฌํ•œ ๋ชฉ์ ์„ ์œ„ํ•œ ์ •๋ณด ์ˆ˜์ง‘์— ๋™์˜ํ•ฉ์„ ์˜๋ฏธํ•ฉ๋‹ˆ๋‹ค. ๋‚˜๋Š” ์—ฌ๊ธฐ์— ์ œ๊ณต๋œ ๋ชจ๋“  ์ •๋ณด๊ฐ€ ๋‚ด๊ฐ€ ์•„๋Š” ํ•œ ์‚ฌ์‹ค์ด๋ฉฐ, ์™„์ „ํ•จ์„ ๋ณด์ฆํ•ฉ๋‹ˆ๋‹ค. ํ—ˆ์œ„ ์ง„์ˆ , ์œ„์กฐ ๋˜๋Š” ๋ˆ„๋ฝ์€ ์„œ๋น„์Šค ํ•ด์ง€ ์‚ฌ์œ ์ž„์„ ์ดํ•ดํ•ฉ๋‹ˆ๋‹ค.

Clientโ€™s Initials (๊ณ ๊ฐ์˜ ์ด๋‹ˆ์…œ)
How did you hear about us? (์šฐ๋ฆฌ์— ๋Œ€ํ•ด ์–ด๋–ป๊ฒŒ ๋“ค์œผ์…จ์Šต๋‹ˆ๊นŒ?)
KIS hosts workshops, events and information sessions. We will keep you inform via email. You will have the option to unsubscribe if you prefer not to receive our monthly newsletter.
์บ ๋ฃน์Šค ์ด์ฃผ๋ฏผ ์„œ๋น„์Šค๋Š” ์›Œํฌ์ƒต, ์ด๋ฒคํŠธ ๋ฐ ์„ค๋ช…ํšŒ๋ฅผ ๊ฐœ์ตœํ•ฉ๋‹ˆ๋‹ค. ์ด๋ฉ”์ผ์„ ํ†ตํ•ด ์•Œ๋ ค๋“œ๋ฆฌ๊ฒ ์Šต๋‹ˆ๋‹ค. ์›”๊ฐ„ ๋‰ด์Šค๋ ˆํ„ฐ ์ˆ˜์‹ ์„ ์›ํ•˜์ง€ ์•Š๋Š” ๊ฒฝ์šฐ ๊ตฌ๋…์„ ์ทจ์†Œํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
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