Deep Diversity Self-directed Registration

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 *

Position:

Organization:

Email *

Phone

I consent to Anima Leadership using my email address for all future communications.

Yes

No

If you are already taking online courses with us, please use the same username and password.

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

Your Attendee Profile

Do you identify as a member of an equity seeking group?

Yes

No

Prefer not to Answer

If Yes:

Payment Method

Checkboxes *

Outside of Canada (international)

In Canada

Payment Currency *

Payment by *

Credit Card

Payment

Name on Card

First

Last Name on Card

Last

Credit Card

Month

BillingAddress

City

State/Province

Zip/Postal

Country

Your Information

The Course

Your Attendee Profile

Payment Method

Payment

Please note that you will have 90 days to complete the course upon registering.