2nd Series Dementia Education Online Workshop Intake Form (Mandarin)

Community Resources for dementia 脑退化社区支援

The dementia education project aims to increase immigrants' knowledge and skills of Dementia prevention and management.
这项目旨在提升移居加国市民对预防及管理认知障碍症的知识及技巧。

Please fill in this form to register for the workshop. It will take you about 3 minutes to complete. The Zoom link will be shared with you 2 days before the workshop. For enquires, please contact 236-880-3261.
请用以下表格报名，需时大约3分钟。讲座的 Zoom 连结会在讲座前两天发送给你。如有查询，请致电236-880-3261。谢谢!
Thank you for registering for the workshop. In addition to your registration, we would like to know a few things about you so we can understand how this workshop helps different kinds of people. Your information will be kept confidential and will be used only to improve future workshops.
感谢你报名参加讲座，我们希望了解你更多，以便评估是次讲座如何帮助不同的人士。你的个人资料会绝对保密，只会作为改善日后讲座之用。
1.
Workshop you would like to join     
您希望参加的讲座是
(Required.)
2.First Name   名(Required.)
3.Last Name 姓(Required.)
4.
Please provide your email address (Zoom link will be sent to this email)
电邮地址 (以便发放ZOOM连结)
5.
Please provide your contact number 联络电话号码 
(Format 填写方法 e.g. 6041234567)
(Required.)
6.Have you attended the first dementia workshop "Introduction to Dementia" on Jan 27th, 2022? 您曾参加在2022年1月27日举行的「齊來认识脑退化」讲座吗?
(Required.)