Skip to content
Image(opens in a new tab)
Contact
EN
EN FR
[google-translator]
EN
EN FR

Your Personal Details

Current Residential Address

Immigration Related Information

This can be a Confirmation of Permanent Residence, a Work Permit, a Refugee Claimant document, a Permanent Resident Card, etc.

If uploading a Permanent Resident Card or other two-sided document, please ensure both sides are attached.
Drop files here or
Accepted file types: pdf, docx, doc, jpg, gif, tiff, Max. file size: 10 MB, Max. files: 1.
    Example: Passport, Drivers License etc.
    Drop files here or
    Accepted file types: pdf, docx, doc, jpg, gif, tiff, Max. file size: 10 MB, Max. files: 1.

      Emergency Contact Information

      Additional information

      Details of Family Members

      Would you like to register your family members so that they can also receive services with us?

      Member 1

      Member 2

      Member 3

      Member 4

      Member 5

      Member 6

      Consents and Confidentiality Statement

      Mail Consent

      I consent to your organization collecting, storing, and using my personal information for the purposes of providing services and communications related to events, workshops, and other relevant activities. I understand that appropriate security measures will be in place to protect my data from unauthorized access or misuse.

      I consent to the sharing of my personal information with trusted third-party partners of your organization solely for the purpose of delivering services and communications as described. I am aware that I have the right to withdraw my consent at any time, which may impact the services provided to me.

      Clear Signature
      Image(opens in a new tab)

      (opens in a new tab)
      • (opens in a new tab)
      • (opens in a new tab)

      NWRIS - Swan

      River 610 Main Street East, Swan River, MB R0L 1Z0

      (opens in a new tab)

      (204) 734-9874

      (opens in a new tab)

      infoswanvalley@nwris.ca

      (opens in a new tab)

      NWRIS - The Pas

      154 Edwards Avenue, The Pas, MB R9A 1S5

      (opens in a new tab)

      (204) 623-3699

      (opens in a new tab)

      infothepas@nwris.ca

      (opens in a new tab)

      NWRIS - Thompson

      205-83 Churchill Drive, Thompson, MB R8N 0L6

      (opens in a new tab)

      (204) 677-8094

      (opens in a new tab)

      infothompson@nwris.ca

      (opens in a new tab)

      Powered by

      Image

      CARMIS (Case Management Solution for Non-Profits)

      (opens in a new tab)