Individual Learning Registration

Username *

First Name (Completing as a group? Enter your lead's name here) *

Last Name *

If you're completing the training as a group, how many additional participants (besides yourself) are in your group?

Additional Participants (If you're completing the training as a group, please list the additional participants' full names here)

Email Address *

Phone Number *

Role - Early Childhood Educator or Director? *

Child care home or centre? *

Licensed or unlicensed? *

Centre Name *

Location - What city/town is your centre located in? *

Choose Password *

Confirm Password *