Expression of Interest

Thank you for taking the time to express your interest in Family Councils Ontario's Building Bridges program. This program is an incredibly important step toward addressing equity, diversity, and inclusion within long-term care communities. 

We thank you for taking the time to express your interest. We will be connecting with all who are interested to let you know more about the program, its requirements, and whether or not you have been selected.

If you have any questions or concerns about this program, please contact Dinesh at dinesh.ram@fco.ngo

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your email address?

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* 4. What is your phone number? 

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* 5. What are your pronouns?

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* 6. How are you connected to long-term care?

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* 7. Which long-term care home(s) are you connected to?

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* 8. Which training & term are you applying for? (Choose only 1 Compassionate Inquiry + 1 Nonviolent Communication. Future terms will offer identical training)

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* 9. If applying for Terms 2 or 3, which day(s) of the week is best for you?

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* 10. If applying for Terms 2 or 3, which time(s) of day is best for you to participate in this program?

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* 11. Please share with us why you are interested in this program and what you hope to gain:

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* 12. Trainings will be via Zoom. Do you have access to your own laptop/pc with webcam and a strong internet connection?

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* 13. Is there any additional information you would like to share with us?

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