Dungeons & Dragons Social Anxiety Support Group Registration (Summer 2024)
Name
*
Given Name
Family Name
Student Number
*
Email
*
Phone Number
Birthday
*
MM slash DD slash YYYY
Emergency Contact
*
Relationship to You
Given Name
Family Name
Emergency Contact Phone Number
*
The best way to contact me is by:
*
calling
emailing
You are a/an:
*
domestic student
Indigenous student
international student
Are you able to attend all the dates of the group?
*
yes
no
Are you registered for classes for the summer 2024 term?
*
Only registered students qualify to join the group.
yes
no
What program are you enrolled in?
*
What is your experience with social anxiety and loneliness?
*
How experienced are you in playing Dungeons and Dragons? All levels welcome!
*
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