Hospice Palliative Care Education

New Learner Application Form

User Information:

Login Preferences:

Email address:*

Re-type Email address:*

Password:*

Re-type Password:*

Personal Contact Information:

First Name:*

Last Name:*

Street:*

Apt/Unit #:

City:*

Province/State:*

Postal Code:*

Contact Phone Number:*

Course Selection:*

Please indicate the course you want to apply for.

Advanced Comprehensive Education for Support Workers (ACE)
Cost:	$35.00
Application Deadline:	Oct 15, 2019
Start Date:	Oct 30, 2019
End Date:	Nov 27, 2019
Session Time:	Wednesday 5:30 PM to 8:30 PM
Facilitator:	Carma Pollock
Location:	Hospice Niagara - 403 Ontario Street, St. Catharines, ON Unit 2
Spaces Available:	8

Fundamentals of Hospice Palliative Care Program - Core Stream
Cost:	$50.00
Application Deadline:	Jan 2, 2020
Start Date:	Jan 7, 2020
End Date:	Feb 11, 2020
Session Time:	Tuesday 9:00 AM to 12:00 PM
Facilitator:	n/a
Location:	Hospice Niagara - 403 Ontario Street, St. Catharines, ON Unit 2
Spaces Available:	20

Fundamentals of Hospice Palliative Care Program - Core Stream
Cost:	$50.00
Application Deadline:	Jan 2, 2020
Start Date:	Jan 16, 2020
End Date:	Feb 20, 2020
Session Time:	Thursday 9:00 AM to 12:00 PM
Facilitator:	n/a
Location:	Hospice Niagara - 403 Ontario Street, St. Catharines, ON Unit 2
Spaces Available:	20

Payment Information:

Please Note:

If the course you select has an associated cost, payment will be required only after you have been accepted for the course. We will review your registration application and you will be notified by email whether or not you have been accepted.

Please ensure your contact information is current.

New Learner Application Form

Login Preferences:

Care Discipline:*

Sign In