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Return to Work seminar

To register for the Return to Work seminar (previously Disability Management), please fill out the form below and click Submit.

Note: * indicates a required field.    

*Contact Name:
(First Name) (Last Name)
*Phone Number:
(with area code)
*Email Address:

*Company Name:


Please use legal company name. Certificate provided
after course completion.

*Company Address:
street
 
city
 
province
 
postal code
*WCB Account #:
(will be verified)
*Are you a third party representative?:
If yes, please enter the WCB Account number of the employer(s):
*Number of Persons registering: (Max. 3)
 
Registrant 1:
(First Name) (Last Name) (Job Title)
    (Email Address)
(Phone Number with area code)
 
Registrant 2:
(First Name) (Last Name) (Job Title)
    (Email Address)
(Phone Number with area code)
 
Registrant 3:
(First Name) (Last Name) (Job Title)
    (Email Address)
(Phone Number with area code)
*Date/Location:
 

Please note:
Each course has a maximum # of registrants. If registrations exceed the maximum you may be contacted to register in another session.

The personal information collected on this form will be used to register you in a WCB seminar with the purpose of assisting employers in the management of workers' compensation claims. This collection of personal information is authorized under Section 33 (c) of the Freedom of Information and Protection of Privacy Act.