Single Mother's Support Group - Contact & Information Form

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Thanks for your interest in joining the Single Mother's Support Group! You are welcome to complete an intake form at at any time. We accept new members into our groups three times a year.

Thank you!

Email *

First Name *

Last Name *

Phone Number *

Municipality - Please select one *

City of North Vancouver

District of North Vancouver

West Vancouver

How did you hear about our Single Mother's Support Group? *

Are you receiving any other community supports or social services? *

Which format of delivery is your preference? *

Online

In-person (with free childcare)

Hybrid (some weeks online and some in-person)

No preference/all are okay

Would you still commit to attend the group if it is not in your first-choice format? *

Yes, I will attend online or in-person.

Can you commit to attend the entire 10-week session (2 hours per meeting, 1 meeting per week on Saturday Mornings, 10am-12pm)? *

Yes, I can commit to attend all 10 weeks.

No, I cannot attend all 10 weeks.

Other:

Do you have any learning or social barriers that you would like to make us aware of? *

Are there any other circumstances in your life or your children's lives that you would like to make us aware of? *

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