Alberta Change Agent Application

Participant Details

First Name

Last Name

Title

Employer

Address

Address Line 2

City/Town

State/Province

ZIP/Postal Code

Country

Preferred Phone Number

Tell Us Why You Want to Participate in the Change Agent Program

What do you personally want to achieve from this program?

Please provide two brief examples of changes you want to see in your organization.

Please upload your current resume

One file only.
2 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

Voluntary Self Identification

WCT is committed to selection based on merit while ensuring full participation of under-represented groups, such as women, those who identify as women and non-binary, Indigenous Peoples, persons with disabilities, and members of visible minority groups and those in the LGBTQ2S+ community. Your response below is voluntary and will be used solely for the purposes of this program.

Please select

I do not identify as a member of an under-represented group

I do identify as a member of an under-represented group

Program Sponsors

Alberta Change Agent Application

WCT Sponsors