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Fine Option Program
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Fine Option Program
Fine Option Program Registration Form
"
*
" indicates required fields
Applicant Contact Info
Name
*
First
Last
Email
*
Enter Email
Confirm Email
Primary Phone
*
Alternate Phone
Date of Birth
*
DD slash MM slash YYYY
Address
*
Street Address
Address Line 2
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Upload Gov't Issued Photo ID
Accepted forms of ID include documents such as your Driver's License or Passport. Skip this field if you do not have a digital copy of this document.
Accepted file types:
JPG/JPEG, PNG, PDF
Max file size:
6 MB (6000 kb)
Drop files here or
Select files
Accepted file types: png, jpg, jpeg, pdf, Max. file size: 6 MB, Max. files: 2.
Court Info
Home Court Location
*
Select...
Regina
Saskatoon
Moose Jaw
Prince Albert
Estevan
La Ronge
Lloydminster
Meadow Lake
Swift Current
Melfort
Weyburn
Wynyard
North Battleford
Yorkton
Out of Province (AB, MB)
Home Court
*
Select...
Saskatoon - Provincial Court
Saskatoon - Municipal Court
Saskatoon - University of Saskatoon
Regina - Provincial Court
Regina - Municipal Court
Moose Jaw - Provincial Court
Prince Albert - Provincial Court
Prince Albert - Municipal Court
Home Court Address
*
Street Address
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Court Date Selection
*
Indicate the day you appeared in court. If you appeared in court for more than one fine on separate days, select "Multiple court dates".
Enter single court date
Multiple court dates
Court Date
*
DD slash MM slash YYYY
Applicant Details
Provision of the information requested in this form is voluntary on your part and does not in any way determine your eligibility for any program. The information will be kept confidential and solely for planning and statistical purposes.
Gender
Select...
Male
Female
Prefer not to say
Other
Gender Identity
Ethnicity
Metis
Status Native
Non-Status Native
Caucasian
Other
Employment Status
Employed
Unemployed
Student
Homemaker
Disabled
Which city would you like to volunteer in?
*
Select...
Regina
Saskatoon
Moose Jaw
Current Placement Opportunities in Saskatoon
Friendship Inn - soup kitchen
Mission Thrift store - Open Tuesday to Friday from 10am to 4pm.
Westside Community Centre - open Tuesdays from 9am to Noon. (Sorting donations)
Organizations of Interest (Saskatoon)
*
Use the field below to indicate which partner organizations you would be most interested in working with. Select all that apply.
Click here
to learn more about our partners.
Friendship Inn
Mission Thrift Store
Westside Community Centre
Organizations of Interest (Regina)
*
Use the field below to indicate which partner organizations you would be most interested in working with. Select all that apply.
Click here
to learn more about our partners.
Al Baaqi Foundation
Al Ritchie Community Association
All Nations Hope Network
Carmichael Outreach
Circle Project
Darul Falah Islamic Center
Ehrlo Sports Venture
Gateway Church
Habitat for Humanity Restore
Hindu Samaj Temple
Indigenous Christian Fellowship
Islamic Association of SK - Regina
Prairie Spirit Connections
Rahmah Centre
Rainbow Youth Centre (YOUTH ONLY)
REACH - Regina Education Action on Child Hunger Inc.
Regina Sikh Temple
Regina Victory Church
St Anthony's Church
The Comeback Society
The Gathering Place
Women of the Dawn Counselling Centre
YWCA Regina
Organizations of Interest (Moose Jaw)
*
Use the field below to indicate which partner organizations you would be most interested in working with. Select all that apply.
Click here
to learn more about our partners.
Canadian Mental Health Association
Hunger in Moose Jaw
Joe's Place
John Howard Society (Moose Jaw Branch)
Moose Jaw & District Senior Citizens Association
Riverside Mission
Salvation Army Moose Jaw
Victory Church of Moose Jaw
Moose Jaw Family Services
New Southern Plains Metis Local #160
Leisure Time Bingo
Are you currently an employee of the work placement organisation(s) chosen?
*
Yes
No
Notice of Fine
Upload Notice
*
Upload the Notice of Fine and Surcharge or Conviction Letter that you received from court.
Accepted File Types:
PDF, JPG/JPEG, PNG
Max files:
5
Drop files here or
Select files
Accepted file types: jpg, jpeg, png, pdf, Max. file size: 5 MB, Max. files: 5.
List Infractions
*
Click the (+) to add a new fine.
File\Ticket No.
Act\CCC
Section
Fine $
Surcharge $
Add
Remove
List Default Days (if any)
Enter date of default for each fine at the line number corresponding to the fines listed above.
Click the (+) to add a new day.
No. of Days
Day
Month
Year
Add
Remove
Total Fines/PVF Surcharges
Minimum Wage
Cash Paid
If you've already paid off a portion of your fines, enter the amount paid here.
Total Hours
The total number of work hours required to pay off your fines.
Decimals will be rounded down to the nearest hour.
(Total Fines - Cash Paid) ÷ Minimum Wage =
COVID-19 Vaccination Status
*
Are you fully vaccinated for the COVID-19 virus? Many placement agencies require you to be fully vaccinated in order to work with them.
Yes, I have received both doses of my vaccination.
No, I am not fully vaccinated.
Prefer not to say.
Privacy Consent
*
I understand and agree to the
privacy policy
.
WCB Consent
*
I understand and agree to the
work-based programs consent and agreement
.
Phone
This field is for validation purposes and should be left unchanged.
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