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Kinship Provider Registration
Name
Username
*
First Name
*
Last Name
*
Password
*
Minimum length of 6 characters.
Repeat Password
*
Biographical Info
Please tell us a little bit about yourself.
Contact Info
E-mail
*
Primary Phone
*
Required phone number format: (###) ###-####
Secondary Phone
Required phone number format: (###) ###-####
Street Address
*
Street Address 2
City
*
Postal Code
*
Who are you associated with?
*
Government
Agency
DFNA
If you provide care/are associated directly with the Government, please choose Government. If you provide care/are associated with an Agency, please select this option then specify with Agency you are associated with.
Agency Name
*
Government
Hull
McMan
Trellis
Closer to Home
Enviros
Woods
Other
Please specify other agency name
*
Worker Name?
*
Worker Office?
*
Worker Email?
*
Please provide your support worker's email address for confirmation of your status as a foster parent.
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Kinship Caregiver Member
Please do not abandon the PayPal portion of this registration or your membership will be stuck in a PENDING state. If this is your first time registering and you have a discount code, there will be a $0.00 payment to activate your subscription.
Kinship Membership
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$
25
/
1 Year
Full access for Calgary Region kinship parents desiring all benefits of CRFKA membership including all events.
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