Faculty Profile Update Form Test

UBC Outdoor Air Quality, Health & the AQHI: registration form

Name(Required)

First Last

Email(Required)

City

Province(Required)

If Outside Canada, please specify your country

Organization/Employer

Please provide your UBC CWL login name (must be valid with activation within 72 hrs of setup)(Required)

This is required to process your course enrolment. To sign up for a UBC CWL account visit this link (copy and paste this URL in your browser): https://activate.id.ubc.ca/iamweb/

==> Select BASIC as the type of account you want to create and click Continue on the above signup page.

You must have activated your CWL account within 72 hours of setup in order for this CWL login name to be valid.

Profession(Required)

Speciality (for physicians and if applicable)

If other, please specify

If you are a healthcare professional, please indicate your practice setting

If other, please specify

Please tell us how you heard of this course(Required)

If other, please specify

Can you tell us why you want to take this course?

Name

This field is for validation purposes and should be left unchanged.

Faculty Profile Update Form Test

UBC Outdoor Air Quality, Health & the AQHI: registration form

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