Search Results

Long-Term Care Counselling Checklist – French

[…] Gender: m Male m Female Union/association membership, if applicable: T he new member will be asked to send HOOPP proof of age documentation. For acceptable proof documents see the Instructions page. New member’s mailing address: Home Tel: Work Tel: E-mail: Fax: New member’s language preference is: m English m French   (See instructions page for details about French services.) 2. Benefit Transfers   (Complete this section, if applicable.)  m The member named above was a member of a pension plan at his/her previous place of employment and wants to explore the possibility of transferring service from that plan into HOOPP. Please indicate,  in the space below, the name of the member’s previous pension plan – for a list of plans with which HOOPP has reciprocal transfer agreements and other details on transfers, see the Instructions page. Date of termination from previous employer: |_____|_____|__________| Previous Plan:  3. Declaration   (Completed by member – see Instructions page.) Iconsent to the use of all information contained on this form and any and all additional personal information which I may hereafter provide to the administrators of the Plan, including my social insurance number, plus information related to my salary and employment record, as may be required to administer the Plan. My consent extends to any disclosures by the Plan administrators to the Plan’ s auditors, actuaries and/or other pr ofessional advisors for the purposes of administering the Plan.  Ialso understand that any information collected or requested via this document is solely for the purpose of administering the Plan and will not be disclosed to any other party, except as previously indicated, without my consent. I certify that the information contained in this form is correct to the best of my knowledge. This form no longer captures beneficiary designation information. See Instructions page for details. New member’s signature: Date: |_____|_____|__________|   4. Employment Information   (To be completed by employer.) Name of employer: Employer code: |___|___|___| New member works:  m […]

[…] is to be completed by the plan administrator• The remaining sections and Beneficiary Designation form are to be comple ted by the plan member• Please print clearly in dark ink using CAPITAL LETTERS. 1 Plan sponsor statement I certify that the plan member listed below is actively at work at their usual place of […]

[…] send to the Toronto Central Hospice Palliative Care Network. Last Modified November2018 2 Home Address : Apt: Entry Code : Postal Code : Lives Alone Young Children in the Home Sm oking in the Home Pet in the Home (specify): Home phone number: Alternate number: Date of birth: (D D/MM/YY) Gender: Faith/Religion: Health card […]

Accessible Employment Policy – French

Accessibility Customer Service Policy – French

ATTESTATION Prepared in accordance with section 14 of the Broader Public Sector Accountability Act, 2010 (“BPSAA” ) To: The Board of Directors to the Toronto Central Local Health Integration Network, operating as Home and Community Care Support Services Toronto Central From: Cynthia Martineau, CEO, Home and Community Care Support Services Toronto Central Re: Quarterly […]