Expression of Interest: LC Dementia Education & Clinical Nursing Leadership Training

This form is for funded Living Classroom education partners (i.e. colleges, school boards, Indigenous Institutes) to express interest in enrolling their PSW or PN student cohort for the dementia education course of their choice, as well as the Clinical Nursing Leadership eLearning course. Education partners with more than one cohort or with both a PSW and PN cohort can submit the form more than once. Expression of interest does not guarantee enrollment. The Research Institute for Aging or a representative from the selected course will contact the education provider to coordinate cohort enrollment.

Section 1: Education Provider & Site Information

Educational Organization

If you are unable to find your organization, please enter it in the text box below.

Educational Organization not listed

Educational Organization

Long-Term Care Partner Name

If you are unable to select your LTC Home from the list, please enter it in the text box below.

Long-Term Care Partner not listed

LTC Home Name

Address Line 1

Address Line 2

City

Province

Postal Code

Please enter the address of the in-person training location.

Address Line 1(Required)

Address Line 2

City(Required)

Province(Required)

Postal Code(Required)

Cohort Start Date(Required)

Cohort start dates must be between April 1st, 2026 and March 31st, 2027.

Number of students in this cohort (estimated)(Required)

Please enter a number greater than or equal to 0.

Section 2: Education Institution Contact Information

Job Title(Required)

Email(Required)

Phone extension

Section 3: Dementia Education Course Selection

Select up to 5 weeks between September 1, 2026 – March 31, 2027 that course may be scheduled. Course provider to coordinate specific dates with you based on availability.

Select “Preferred Start Date” for your cohort between September 1, 2026 – March 31, 2027. Course provider to coordinate specific dates of program availability with you.

Preferred Week 1(Required)