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* 1. First Name

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* 2. Last Name

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* 3. Email address

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* 4. I am a

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* 5. I am a student at / recent alumni from
(please enter the name of your post-secondary institution)

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* 6. I would like to:
(please select all that apply)

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* 7. I am interested in attending the event and I am available the following dates:
(please select all that apply)

Please note that the strategic planning event for the group will take place on a Saturday from approximately 11am-5pm downtown Vancouver.
Some travel support will be available through Healthy Minds/Healthy Campuses and/or your post-secondary institution.

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