PARTICIPANT INFORMATION FOR ONLINE COURSE

Are you interested in joining Living life to the Full remotely? Due to this challenging  situation we are experiencing currently, the program team is setting up the course in a new format so you can grow self-empowerment skills from the comfort of your home and connect with other members of your community. 

As the team is still working on launching this new format, this questionnaire will serve as a waiting list until there is a spot available for you to join the course online. 

Please note that the information you will provide in  this questionnaire will only be handled by the Canadian Mental Health BC Division Team and will only be shared with your future course facilitator. 

Thank you for joining this new adventure!

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* 1. First Name 

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* 2. Last Name

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* 3. Email Address

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* 4. Phone number

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* 5. What language you would like to take the course in?

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* 6. Province

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* 7. City/Town

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* 8. Age Bracket

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* 9. Is there anything you would like us to know?

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