Manitoba Income Support Programs Intake Application Appointment Request Form

This form is not an application form and submitting the form does not guarantee eligibility for Employment and Income Assistance or Manitoba Supports for Persons with Disabilities benefits.

You will be contacted by Manitoba Income Support programs staff who will answer any questions you have, collect additional information and schedule your intake appointment.

If you want to make changes, such as correct an error, change your information or cancel your application you may do so when the Manitoba Income Support programs staff contact you.

Manitoba Income Support Programs Intake Application Appointment Request Form

Personal Information

Application Status

Previous Enrollment