CCA Intake Interest Questionnaire
Please note, this survey is to determine eligibility
and interest in the program.
This is not an application to the program.
*
1.
First Name
(Required.)
*
2.
Last Name
(Required.)
*
3.
Email Address
(Required.)
*
4.
Are you a permanent resident of Nova Scotia?
(Required.)
Yes
No
25%
