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Intercultural Leadership Survey
TORONTO "INTERCULTURAL LEADERSHIP AND LEARNING" Pre-course survey

The course is in part shaped by the experiences and needs of the course participants. This survey will help the course facilitators and resource people shape activities and content.

Your name (and preferred name) will be used for course certificates and name tags.

It is optional to provide your contact information and it will only be shared with your permission.
Through your participation in this program you will be invited to connect with a Canadian ecumenical network of intercultural ministry practitioners through the Forum for Intercultural Leadership and Learning (FILL) of the Canadian Council of Churches (CCC). This network will offer resources, courses, and other support.

Contact information:

Please see the "permission to share" check boxes below. Your contact information will only be shared with your permission.
Full name (first and last)
(For informal conversation, on name tags, etc.)
Address
Street address
Street address line 2 (optional)
City
State/Province
Zip/Postal
Country
I give permission for my email address to be shared with other course participants:
E-mails are shared to help connect participants during and after the course so they may be a resource and support to each other.
I give permission for my phone number(s) to be shared with other course participants.
Phone numbers are shared to help connect participants during and after the course so they may be a resource and support to each other.
I give permission for my mailing address to be shared with other course participants:
Addresses are shared to help connect participants during and after the course so they may be a resource and support to each other.
I give permission to add my email address to the monthly "Intercultural Ministry" e-newsletter
This e-newsletter is sent aproximately once a month. It is meant to help support and foster a network of Canadian Ecumenical intercultural ministry practitioners. The enewsletter includes other course and program opportunities as well as other resourses for intercultural ministry. It is sent blind copy so your email address is not shared. You may remove yourself from the e-mailing list at any time.

Personal and Family information:

The program is shaped by the the community of people who gather. The information you share in the following sections will be kept confidential and used to provide a summary of the group without identifying individuals. This summary is shared with the program designers, facilitators, and resource people to help shape sessions.

Course related information:

The course is designed so that sessions build on each other and are within a learning community. It is important that you are present for the full course.

Please refer to the course QUERCUS page for the program schedule..

Special Accommodation and Other Needs:

Notes on the registration

Once you click "submit registration", there will be a message to confirm successful submission of this form or you will be asked to resubmit with missed information.

An automated email will be sent to confirm that we have received your registration. If it does not arrive in your inbox, please check your "junk mail" or "spam" folder.