Montreal Region PNP3 Registration Form

Eligibility

I confirm that I am a current serving member of the Canadian Armed Forces and meet the eligibility criteria.

Montreal Region community

* required

Name

Last Name

Service number

Preferred method of communication

E-mail* Telephone

* required

E-mail

* required

Telephone

Status

Prenatal Postpartum ˂ 18 months

* required

Consent

I consent to be contacted by the PNP3 Evaluation Team throughout participation in PNP3 including during Maternity and Parental Allowances (MATA/PATA). Emails will be securely stored and kept confidential.  Emails will be used for the purposes of providing feedback on your experiences with PNP3, track the success of PNP3 at achieving its intended outcomes, and to help improve the program and its offerings.

Privacy notice

I confirm that I have read the PRIVACY NOTICE.

Consent agreement

By registering to this program or activity, I consent to the collection and use of my personal information as described in the privacy notice above.

** Please consider that you may not have access to your @forces e-mail account while on MATA/PATA. We recommend that you insert a personal e-mail in this form. 