Confirmation – 2022 Governor General’s Canadian Leadership Conference

Please complete the following form to confirm your participation to the 2022 Governor General's Canadian Leadership Conference (GGCLC).
Delegates have until Monday, May 31st, 2021 to submit this form.
If the information requested below has not changed since you applied to the Conference, please leave the response fields blank.

Important - Pressing "Enter" will automatically submit this form. We encourage you not to use this command while answering the questions below.

CONFIRMING PARTICIPATION AND COMMITMENT TO THE GGCLC PROGRAM
I confirm my participation to the 2022 edition of the GGCLC Conference, and commit to attend/participate actively in the monthly virtual discussion meetings when the program resumes in the Fall of 2021I cannot attend the Conference in 2022 and therefore must withdraw my participation

PERSONAL INFORMATION

First Name (required)

Last Name (required)

Email Address (required)

HOME COORDINATES
My home coordinates have not changed since I submitted my application in 2019.

Home Address

Home City

Home Province/Territory
Click to selectAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon(Other/International)

Home Postal Code

Home Telephone

PROFESSIONAL INFORMATION
My professional information and coordinates have not changed since I submitted my application in 2019.

Professional Sector
Click to selectBusinessLabourFederal GovernmentProvincial GovernmentMunicipal GovernmentNGOArts and CultureEducationHealthOther

Position/Title

Organization

Address

City

Province/Territory
Click to selectAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon

Postal Code

Telephone

Cellular

Email Address

IMPORTANT - Please send us a revised biography and photo if you changed position or employment since you were selected as a participant

OPTIONAL SURVEY
To help us better plan your Conference and enhance safety protocols, we invite you complete this optional small survey.

1. Do you expect/plan to get vaccinated for COVID-19?
YesNoUndecidedI cannot get vaccinated due to a medical condition

2. In your opinion, should the GGCLC consider making vaccination mandatory for participants to attend the Conference?
YesNoUnsure

3. Starting this fall, the monthly virtual meetings (and debriefing sessions) will become an integral part of the GGCLC experience. Considering all the sessions that were held to date, are there any additional topics that you would like to suggest for consideration and further exploration/discussion?

4. Additional Comments?

For more information, please contact us at info@leadershipcanada.ca