CiiAT CATD Enrolment

Last Name *

Your family name

First and Middle Name(s) *

Your first and middle or given names

Usual First Name *

Mailing Address *

Student Telephone Number (with country code) *

Student Email Address *

Date of Birth *

YYYYMMDD

Gender

I'm afraid we're mandated by the government school authority to ask this question.

Do you identify yourself as an Aboriginal person, that is, First Nations, Métis, or Inuit?

If you answered “Yes”, please indicate if you are:

Do you have a long-term physical or mental health condition that limits the kind of activity that you can perform on a daily basis?

CiiAT