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Application Form for Oral Health Literacy Training 

Please fill in your information below so we can be in contact about your application. Allow about 15-20 minutes to read through the information and answer all of the questions below. 

TRAINING DATES

Module 1: The Importance of Oral Health
Tuesday, November 24th at 2pm (MST)

Module 2: Planning a Community Event
Tuesday, December 1st at 2pm (MST)

Module 3: Customizing and Sharing Your Plan
Tuesday, December 8th at 2pm (MST)

Module 4: Follow-Up and Evaluations
Tuesday March 30th at 2pm (MST)

**Plus at least one check in with the Community Oral Health Literacy Coordinator at a date and time of your choosing and as needed.** 

Please note that all training will take place online. Up to 10 participants will be accepted into the training. All participants must agree to organize their own oral health event between January and mid-March 2021 and can apply for a grant of up to $1500 from NWTLC. You will also receive continued support from NWTLC's Community Oral Health Literacy Coordinator during the trainings and one-on-one sessions, as desired.

Selected applicants will be contacted the week of November 9th with more information. Only applicants chosen for the program will be contacted. If you have any questions please contact Stephanie, the coordinator, at stephanie@nwtliteracy.ca. 

Please note: Priority will be given to applicants from communities with less access to oral health care services.

<<<Deadline to apply is Thursday, November 5th at 11:59pm.>>>



1.Please provide the following contact information below:(Required.)
2.How do you prefer to be contacted (email/work phone/cell phone) and during what hours of the day (morning/afternoon/evening)?(Required.)
3.What is the name of the organization you work for?(Required.)
4.What is your position or job title?(Required.)
5.What is your mailing address?(Required.)
6.Why is promoting community healthy living important to you?(Required.)
7.Please share your experience with organizing events or facilitating programs.(Required.)
8.Have you taken training with the NWT Literacy Council before? (Required.)
9.Can you commit to 10 hours of online training and the additional time (estimate an additional 20 hours +) it will take you to plan your community event ?(Required.)
10.Do you have access to a computer and reliable Internet access for training purposes?

Please note, if/when Internet is unavailable, you may phone into the training session.
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