Please note that you will not receive a confirmation message after submitting your registration. Unless you receive an error notification we have received your request. Due to the heavy volume of registrations, and depending on if you need a new account set up it may be a few days before you receive your login instructions. Thanks for your patience.

Date:

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* 1. Date:

Date / Time
First Name

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* 2. First Name

Middle Initial (or N/A)

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* 3. Middle Initial (or N/A)

Last Name

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* 4. Last Name

Preferred Email Address (all correspondence will go to this email)

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* 5. Preferred Email Address (all correspondence will go to this email)

Alternate email (in case your preferred email changes)

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* 6. Alternate email (in case your preferred email changes)

Preferred Phone Number

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* 7. Preferred Phone Number

Alternate Phone Number

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* 8. Alternate Phone Number

Have you been enrolled in the CPD program before; or have a University of Calgary user account?

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* 9. Have you been enrolled in the CPD program before; or have a University of Calgary user account?

Place of Employment

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* 10. Place of Employment

Do you work in an urban or rural setting? (select both if it applies)

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* 11. Do you work in an urban or rural setting? (select both if it applies)

City/Town

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* 12. City/Town

Do you currently provide clinical services to children or youth with addiction or mental health issues?

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* 14. Do you currently provide clinical services to children or youth with addiction or mental health issues?

Your Professional Education (Registered professions / Master's Degree preferred). If you are in Education, please see the MORE program at www.hmhc.ca/more.html 

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* 15. Your Professional Education (Registered professions / Master's Degree preferred). If you are in Education, please see the MORE program at www.hmhc.ca/more.html 

When the courses are closed at the end of the month, would you like to be automatically enrolled in the archived version of the course?

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* 16. When the courses are closed at the end of the month, would you like to be automatically enrolled in the archived version of the course?

If the course is full when we receive your registration, would you be willing to instead take a shorter (no discussion board) archived version of the same course, for partial credit?

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* 17. If the course is full when we receive your registration, would you be willing to instead take a shorter (no discussion board) archived version of the same course, for partial credit?

How Did You Hear About Us?

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* 18. How Did You Hear About Us?

Please enter any comments here.

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* 19. Please enter any comments here.

Please select which course you would like to enroll in:

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* 20. Please select which course you would like to enroll in:

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