Self Advocate Social Events Survey Form

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Are you a self-advocate? *

Where are you located? *

Will you be able to travel to our office in Vancouver? *

Our office address is 18/F, 450 SW Marine Drive, Vancouver. It is a 3-minute accessible walk from the Marine Drive Station on the Canada Line.

What is your availability? *

What is your availability? *

What is your email? *

We will use it to tell you about our next events. You can leave this blank if you prefer.

What is your phone number?

We will add you to our WhatsApp group to tell you about future events. You can leave this blank if you prefer.

any Are of

Are you interested in any of the social activities below? *

Are you interested in any of the creative activities below? *

Are you interested in any of the health and wellness activities below? *

Do you have any more activity ideas?

Do you have any accessibility needs?

Join Our Community

* indicates required

First Name *

Last Name *

Email Address *

City / Location *

Agency / Organization *

Connection to Home Sharing *

If Other please Describe

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