Friendship and Dating Program Application Form - V1.1 - 2023-12-14

Sep 19, 2026

Friendship and Dating Program application form for collecting applicant and support details needed for enrollment decisions. Gathers personal information, contact and address, legal guardianship status and guardian contacts, communication and assistive needs, transportation access preferences, and medical or allergy concerns for emergency planning. Includes program session selection (fall or winter), waitlist preference, affordability for weekly activities, membership and Fair Entry card questions, and attendance commitment confirmation across all 10 weeks.

LanguageEnglish

CategoryForms

FormatPDF

Pages2

Reading Time1 min

AccessFree to download

Applicant Information

Additional Information

Friendship and Dating Program | Applicant Information | | | | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | | Name: | | | | | Gender Identity:
*optional* | | Pronouns:
*optional* | | Age: | | Phone Number: | | | | | | Email: | | | | | Address: | NUMBER STREET CITY PROVINCE POSTAL CODE | | | | | | | | | | Are you your own legal guardian? | | | YES
NO | If NO, what is the full name of your legal guardian? | | | | | | | | | | | | | | | | | | | | | | | | | | | | | If applicable, what is your legal guardian’s contact information? | | | | | | | | | | | Who are your CASS Coordinators? | | | | | | | | | | | Communication/Assistive Needs | | | | | | | | | | | The Friendship & Dating Program uses some written material as part of its curriculum. Do you need any support with
reading, writing, or understanding written documents? YES NO
If you do need support, who helps you with this? | | | | | | | | | | | It is the individual’s responsibility to get to and from the group’s community activities. Will you require assistance
from a support staff to help you access the program? YES NO
Please describe the type of assistance you require: | | | | | | | | | | | Please indicate your means of transportation to and from the group?
ACCESS Calgary Calgary Transit Staff Vehicle Other (please specify): | | | | | | | | | | | Medical Needs | | | | | | | | | | | Are there any medical concerns (e.g. seizure disorders, allergies, etc. ) that we need to be aware of in case of an
emergency? Yes No
If Yes, please list here: | | | | | | | | | | | Do you have any allergies (e.g., food, environmental)? Yes No
If Yes, please list here: | | | | | | | | | | Friendships and Dating Application Form ‐ Amendable Dates ‐ V1 .1 ‐ 2023‐12‐14 Page 1 of 2 | Additional Information | | --- | | Friendships and Dating will be running two programs, a fall and winter course. Which session would you like to
attend? Fall (October to December)
Winter (January to April)
Enrollment in the Friendship and Dating program is limited, if you do not get a spot in the current session,
would you like to be placed on a wait list for future classes? Yes No | | Friendships and Dating is a ten week program that focuses on both class and community learning opportunities. The facilitators of this program will do our best to plan as many free community activities as possible, however there may be some activities that cost money. Please indicate what you can afford on a weekly basis to participate in the program:
No budget $0‐$5 $5‐$8 $8‐$12 $12‐$15
Do you have annual memberships to any community organizations (e.g., Calgary Zoo, YMCA, Telus Spark, Heritage Park, etc. ): YES NO
If YES, please specify:
Do you have a City of Calgary Fair Entry card? YES NO | | When you agree to attend the Friendships and Dating program, it is important to commit to attending all sessions from start to finish. It is a big commitment!
Is there anything that could get in the way of your ability to attend ALL 10 weeks of classes?
If YES, please specify:
Is there any place in the city you are not comfortable going to? YES NO
If YES, please indicate where:
Please confirm that you can attend all 10 weeks, two times per week, of the Friendships and Dating sessions?
YES NO | | Further Information | | What do you want to learn or get from this course? | If you have any questions about the Friendships and Dating Program, or this application form, please contact the CASS office at (403) 283‐0611 or email [friendship@c‐a‐s‐s.org](friendship@c‐a‐s‐s.org) Please submit this form via email to [friendship@c‐a‐s‐s.org](friendship@c‐a‐s‐s.org) or in person at the CASS Main Office. Friendships and Dating Application Form ‐ Amendable Dates ‐ V1 .1 ‐ 2023‐12‐14 Page 2

FAQs

What personal and contact information does the form request?

The form requests the applicant’s name, gender identity (optional), pronouns (optional), age, phone number, email, and full address including street, city, province, and postal code.

What details are collected if the applicant is not their own legal guardian?

If the applicant is not their own legal guardian, the form asks for the legal guardian’s full name and contact information.

Which program session and participation details must be confirmed?

Applicants select either the fall (October to December) or winter (January to April) session, indicate whether they want a wait list, specify what weekly budget they can afford, and confirm they can attend all 10 weeks (two times per week) and all sessions from start to finish.

Sep 19, 2026

Upload by Jordan Avery