Full Certificate Registration Register for all four courses in our Inclusive Management Certificate using this form, and receive a discount of $125. ALLCERT Your Information If you are registering for another person, please put their information in the fields below, and select the “I am registering for another person” checkbox at the bottom of this section. First Name * Last Name * Preferred Pronouns How do you prefer to be referred to? Position: Organization: Email * Phone Already Registered for another Anima Online course? Yes, I’m already registered. Please add this course to my existing account. If you are already taking online courses with us and want to add these courses to your existing Anima Online account, select this checkbox. Username * Your Username has to be all lower case letters, with no spaces or special characters. We recommend using your first and last name, run together as one word. Or, you can make up something unique. Minimum length is 5 characters, and maximum is 20. Password * A password is required to access the course materials. If you have already registered for a previous Anima Online course, you can either use the same password, or enter a new one to reset your password for all courses. Confirm Password * Please reenter your password to confirm. Registering for another person I am registering for another person My Name * My Email * My Phone * The Course Course Selection Full Inclusive Management Online Certificate Includes the following courses: Deep Diversity Authentic Facilitation Brave Conversations Authentic Management Special Notes Complications? If you have already completed some of the above courses, or have already registered under a different email address, or have other concerns, let us know and we will make any necessary adjustments. Your Attendee Profile Do you identify as a member of an equity seeking group? Yes No Prefer not to Answer If Yes: Aboriginal/Indigenous Person with Disability Member of a Visible Minority/Racialized/Person of Colour Woman LGBTQ2S OtherOther My level of knowledge on issues of diversity and inclusion is: 1 2 3 4 5 6 7 8 9 10 1-10 where 1 is minimal and 10 is very experienced Are you in a management role? Yes No No, but I hope to be Anima will be recording each webinar and chat for internal use by you and other participants for learning purposes (e.g. missed sessions, review of concepts). This will include the plenary sessions but the small group breakouts will NOT be recorded. I understand and consent to the course sessions being recorded and shared with other participants. Yes No If you answered “no,” you are invited to keep your audio and video off during the plenary sessions. During the small group breakouts, however, you are encouraged to keep your audio/video “ON” to enhance the participation and learning for yourself and others. After workshops people often ask for contact information of participants. Do you consent to having your name, email and organization shared with other participants as part of the workshop package? Yes No Participation and Expectations Do you require any accommodations or have any accessibility issues? Yes No Please describe any required accommodations that would support your learning experience? Please tell us a bit about yourself and your expectations for the course: Payment Method Payment Currency * Select your payment currency… Canadian (CAD) International (USD) Payment by * Credit Card Payment as previously arranged Payment is typically by credit card. If you have made other arrangements, such as payment by invoice, select ‘Payment as previously arranged’ here. Payment Arrangements Thank you – Please continue with your registration, clicking the Submit button at the bottom of the form when you are done. You will bypass the online payment screen. If you have any questions about your payment arrangements, contact info@animaleadership.com Coupon Coupon Code I have a Coupon Code issued by Anima Leadership Enter your Coupon Code, here: If you have been given a coupon code, enter it here. If you have questions about the code, contact info@animaleadership.com Billing Information Pre-Tax Price HST Total Price Coupon Payment Agreed Pre-Tax Price Enter the agreed pre-tax price here. 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