This form can be filled out by the service agency's representative, or by the Food Processing Skills Canada (FPSC) coordinator as they discuss the project. This form is designed to collect information that will help FPSC program coordinators understand some basic information about the service agencies who are enrolled in the program. We will use the information that you provide on this form to understand what types of training might be of most benefit to your clients, and to highlight specific skills and areas of potential interest for your service agency.

*** Information you provide on this form will be used for FPSC program purposes only ***

Service Agency Contact Information

Are you a Food Processing Skills Canada member?

Yes

I'm not sure

Service Agency name

Website

Main Contact

Main Contact First Name:

Main Contact Last Name:

Main Contact Title:

Main Contact Telephone:

Main Contact Email:

Alternate Contact

Alternate Contact First Name:

Alternate Contact Last Name:

Alternate Contact Title:

Alternate Contact Telephone:

Alternate Contact Email:

New Contact

Same as main contact

Service Agency Location

Single Location

Main Office

Branch Office

Main Office

Is your agency a branch of another agency? If so, please select the main office from the list below. If your main office is not listed below select "not listed"

Street Number

Apt/Unit Number

Street Name

Town/City

Province

Postal Code

Ship items to this address

Add more

Describing your clients

Number of clients served in previous 12 months for:

Training Programs
Support Services

Types of clients served in the previous 12 months (please estimate %):

Under 30 years of age
55 years and older
English/French as a second language
Recent immigrant within past 5 years
Member of a visible minority/racialized group
Member of LGBTQ2S+ community

Type of disabilities or differences among clients (please estimate %) :

Physical differences	These affect how someone senses things, moves, handles objects, or keeps up their energy. The causes of physical disabilities can vary – it can be hereditary, or inherited, or the result of accident, injury, illness, traumatic event or post-surgery effects.
Developmental or learning and growth differences	These start in childhood and can affect how someone learns, talks, or takes care of themselves. Examples include Autism Spectrum (ASD), Cerebral Palsy, Fragile X Syndrome, Intellectual Disability, Language Disorder, Tourette Syndrome, Epilepsy, Down Syndrome.
Neurodiverse or brain and behavioural differences	These affect how someone thinks, sees the world, interacts, or controls their actions. ADHD, Autism, Dyspraxia, and Dyslexia all fall within the spectrum of “Neurodiversity” and are all neurodiverse conditions.
Episodic or fluctuating differences	These come and go, with times when they're more or less intense, common, or long-lasting. These may include disabilities related to long-COVID, multiple sclerosis, IBS, lupus, arthritis, cancer, HIV, diabetes and personal anxieties.

Employer Engagement

What types of support services does your service agency provide to individual clients? (select all the apply)

Job fairs

Networking events

Direct outreach (e.g., cold calling, emails)

partnerships with industry associations

Other

What are the primary challenges your service agency faces when engaging with employers?

Training and Supports

What types of training programs does your training agency offer to individuals with disabilities? (select all the apply)

Job readiness training

Technical skills training

Soft skills training

Internships of apprenticeships

Other

What types of support services does your organization provide to individuals with disabilities? (select all the apply)

Job coaching

Mentorship programs

Transportation assistance

Other

Data Collection and Reporting

How does your service agency collect data on employment outcomes? (select all the apply)

Surveys

Interviews

Employer feedback

Job placement tracking systems

Other

How frequently does your service agency report data/results to funders? (select all the apply)

Monthly

Quarterly

Annually

Other

What challenges does your service agency face in collecting and reporting data?

Additional Comments

What additional supports or resources would help your service agency improve its employment services for individuals with disabilities?

Please share any innovative practices or successful strategies your service agency has implemented to improve employment outcomes for individuals with disabilities?

FoodAbility Implementation Considerations

Who is our contact at your service agency to onboard and update regarding training programming?

Onsite Contact First Name:

Onsite Contact Last Name:

Onsite Contact Title:

Onsite Contact Telephone:

Onsite Contact Email:

New Contact

Same as main contact

Same as alternate contact

Approximately what proportion of clients overall might have challenges with language skills and literacy within the context of on-line learning?

Approximately what proportion of clients overall might have challenges with computer skills within the context of on-line learning??

Are there any other considerations that should be made for implementing this program with your service agency?

I understand that individuals that contribute to the setting of the FPSC's competency standards, certifications, accreditations or training programs may be acknowledged from time to time (e.g. in printed material, social media, on the FPSC website).

Service Agency Contact Information

Main Contact

Alternate Contact

Service Agency Location

Describing the Service Agency

Describing your clients

Employment Sectors

Employer Engagement

Training and Supports

Data Collection and Reporting

Additional Comments

FoodAbility Implementation Considerations