Available to residents of Canada only - Please fill out the form below to receive one resource kit.
Due to the great demand please allow 6 - 8 weeks for delivery.
Language:
English
French
Date:
mm/dd/yy
Salutation:
Mr.
Mrs.
Ms.
Dr.
Rev.
First Name:
Last Name:
Street:
City:
Province:
Postal Code:
Country:
Canada
Business Phone:
Home/Evening Phone:
Fax:
E-mail:
How did you hear about the Foundation?
Choose one
Calendar
TV Commercial
Magazine
Media
Newspaper
Search Engine
Transit
Other
Who is the information for?
Parent
Expectant Parent
Caregiver
Media
Policy Maker
NGO, Foundation
School/Teacher/Principal
Physician/Nurse
Professor/Researcher
Psychiatrist/Psychologist/Social Worker
Corporation
If parent; age of youngest child:
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Question or comment: