Land Based Course Registration

First Name:

Last Name:

Email Address:

Phone Number:

Gender:
Male Female Other

Employment Status:
Full Time Part Time Unemployed

I Identify as Indigenous to Canada:
First Nations Inuit Metis Don't Identify

Please Specify Nation/Commuinity:

Where did you learn about the Continuing Education program?

If you have any questions about the program or the application, contact Adrienne Vandahl at adrienne.vandahl@aets.org