* 1. First Name

* 2. Middle Initial (or n/a)

* 3. Last Name

* 4. Preferred Email Address (All correspondence from the HMHC MORE Program will go to this email address.)

* 5. Preferred Phone Number

* 6. Have you previously been enrolled at the University of Calgary, MORE or CPD programs? (E.g. Full or part-time student; Continuing Ed Student)*

* 7. City / Town

* 9. Grades you teach / age group you offer service to

* 11. Is your school in an Urban or Rural area? (select both if you work in both settings)

* 12. School District (click as many as are applicable)

* 13. Workplace postal code (if you work in multiple areas, enter one)

* 15. Please select which Alberta Health Services Zone your teach / work in. An image can be found at for reference

* 16. How did you hear about us?

* 17. Please choose which courses you would like to be registered in: