Employer: Scarborough Unsolicited

How did you hear about us?: * Required

Corportate Business Name: * Required

Registered Legal Name: * Required

Contact First Name: * Required

Contact Last Name: * Required

Canada Revenue Agency/Business: * Required

Choose the industry that best represents your business? * Required

Total Number of Employees in Corporation

* Required

Employer Business Size * Required

Year Business Registered (YYYY):

* Required

Preferred Language: * Required

Preferred Communication: Phone:

Preferred Communication: Email:

Email: * Required

Password (for future login): * Required Show Password

Confirm password

Password must contain the following:
A lowercase letter
A capital (uppercase) letter
A number
Minimum 6 characters
Both passwords should match

Work Phone (include ext, if applicable): * Required

Cell Phone (include ext, if applicable):

Corporate Street Number/Address: * Required

Corporate Address Unit Number (if applicable):

Corporate City/Town: * Required

Corporate Province:

Corporate Postal Code: * Required

Corporate PO Box:

Closest major intersection, if applicable:

Type of Business: * Required

Type of Sector: * Required

If other sector, specify:

Briefly describe your business and the types of occupations it supports:

Is your company currently/ recently involved in lay-offs?: * Required

Do you have third party liability coverage?:

Which type of workplace safety insurance do you have?:

If selected alternative workplace safety insurance coverage, specify:

Read here: Employer Communication Consent, Waiver, Release and Indemnity Agreement

Employer Communication Consent, Waiver, Release and Indemnity Agreement: I agree/I do not agree * Required


Employer Application How did you hear about us?: * Required Corportate Business Name: * Required Registered Legal Name: * Required Contact First Name: * Required Contact Last Name: * Required Canada Revenue Agency/Business: * Required Choose the industry that best represents your business? * Required Total Number of Employees in Corporation * Required Employer Business Size * Required Year Business Registered (YYYY): * Required Preferred Language: * Required Preferred Communication: Phone: Preferred Communication: Email: Email: * Required Password (for future login): * Required Show Password Confirm password Password must contain the following: A lowercase letter A capital (uppercase) letter A number Minimum 6 characters Both passwords should match Work Phone (include ext, if applicable): * Required Cell Phone (include ext, if applicable): Corporate Street Number/Address: * Required Corporate Address Unit Number (if applicable): Corporate City/Town: * Required Corporate Province: Corporate Postal Code: * Required Corporate PO Box: Closest major intersection, if applicable: Type of Business: * Required Type of Sector: * Required If other sector, specify: Briefly describe your business and the types of occupations it supports: Is your company currently/ recently involved in lay-offs?: * Required Do you have third party liability coverage?: Which type of workplace safety insurance do you have?: If selected alternative workplace safety insurance coverage, specify: Read here: Employer Communication Consent, Waiver, Release and Indemnity Agreement Employer Communication Consent, Waiver, Release and Indemnity Agreement: I agree/I do not agree * Required Please leave this checkbox blank