Please complete this form to apply for YouthREX’s Online Certificate: Program Evaluation for Youth Wellbeing.
We will review all the applications and get back to you with an application decision by December 11, 2017.
Please note that space is limited and priority will be given to those who are currently working directly in Ontario's youth sector. Information provided will only be used for the purpose of this certificate unless you indicate otherwise.
If you have any questions, please email To learn more about this online certificate, visit our website!

* 1. Do you live and work in the province of Ontario?

* 2. First Name

* 3. Last Name

* 4. Email Address

* 5. Phone Number

* 6. City

* 7. Organization Name

* 8. Program Name (if applicable)