Name *

First Name

Last Name

Do you have low income? *

Defined here as $35,000 or less per year

yes

no

prefer not to say

Do you identify as Black, Indigenous or a person of colour? *

yes

no

prefer not to say

Do you identify as a member of the 2SLGBTQIA+ community? *

yes

no

prefer not to say

Do you face a physical or mental disability or illness? *

yes

no

prefer not to say

Are you an immigrant or refugee? *

yes

no

prefer not to say

Are you formerly incarcerated?

yes

no

prefer not to say

Are you able to pay the remaining $350+GST for the training program? *

Yes

No

Not sure