Jobs Protection Office 2378 Holly Lane, Suite 202 Ottawa ON K1V 7P1 Toll Free: 1 888 998-9959 Telephone: 613 260-8351 Fax: 613 260-8369
Ontario-Quebec Construction Labour Mobility Agreement
New Registration Amendment Renewal
Registration No.
Applicant Last Name Applicant First Name
Unit No. Street No. Street Name PO Box City/Town Province Postal Code
Home Telephone No. Cell No. Fax No. Email
Employer Name Position
Telephone No. Fax No. Project Location
I, the undersigned, declare that the information provided and attached is true and complete. I authorize the Jobs Protection Office to verify all information included in this application. Falsification of information will lead to cancellation of this application.
Applicant Signature Applicant Signature Date (yyyy/mm/dd)
Trade Activities Proof of MTCU Evaluation (attached) Copies of paystub/T-4 or Notice of Assessment Proof of H&S Training Processor Name Processor Date (yyyy/mm/dd) Approver (Director, Jobs Protection office) Approver Date (yyyy/mm/dd)