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Adult Registration Form

Date
Jour
Mois
Année
Date of Birth
Jour
Mois
Année
Age
0-17
18-34
35-54
55+
Gender
Male
Female
Other
Not willing to disclose
Are you new to Rainbow Literacy?
Yes
No
I identify as:
First Nations/Metis/Inuit
Immigrant/Temporary Resident/Refugee
Highest level of school received:
No Schooling
Grades 1-6
Grades 7-9
High School
Some Post-Secondary
Post Secondary Grad
Special Education
Prefer not to say
Best way to contact you?
Do you need babysitting?
Yes
No
Do you need to be subsidized?
Yes
No

(403) 485-3107

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