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.

* 1. Date:

Date / Time
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* 2. First Name

* 3. Middle Initial (or N/A)

* 4. Last Name

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

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

* 7. Preferred Phone Number

* 8. Alternate Phone Number

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

* 10. Place of Employment

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

* 12. City/Town

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

* 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 

* 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?

* 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?

* 18. How Did You Hear About Us?

* 19. Please enter any comments here.

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

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