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CBS Registration

Please fill out the following forms to complete your profile with Community Based Services.

Note: All information is confidential and collected according to BC Personal Information Protection Act (PIPA) guidelines. Refer to the NSDRC Privacy Policy for more information.

804A Community Based Services Registration
Program *
Please select the program(s) you are registering into

Participant Profile Information

Participant Address *
Participant Address
City
State/Province
Zip/Postal

Primary Contact Information

If no email address, please enter none@none.org.
I consent to the NSDRC contacting me through this email address for all program related information. *
I may withdraw this consent at any time.
Primary Contact Address *
Primary Contact Address
Primary Contact Address
City
State/Province
Zip/Postal

Secondary Contact Information

Secondary Contact Address
Address
Address
City
State/Province
Zip/Postal
Country

Emergency Contact Information

Emergency Contact Address
Emergency Contact Address
City
State/Province
Zip/Postal
Country

won't you join us?

Each of us has a role to play in creating the community we want to live, work and play in. Join our email list to keep up to date on NSDRC news. Let's build a better community together!

North Shore Disability Resource Centre

3158 Mountain Highway

North Vancouver, BC

V7K 2H5

phone: 604-985-5371

fax: 604-985-7594

email: nsdrc@nsdrc.org

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United Way member agency

The NSDRC was started by a group of families in 1976. In the years since, we have worked for a "Community for All" by developing and providing residential services, infant development programs, youth groups, community based services, and information and advocacy.