BECOMING A CHILDREN'S RESPITE CAREGIVER - EXPRESSION OF INTEREST
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Please enter the letters or numbers exactly as they appear.
Name
Address
Home Phone
Cell Phone
Email
In home
Community
Emergency respite (on call)
Check which respite options are you interested in.
Describe the child / youth you believe you would enjoy supporting.
Do you have any training or experience caring or a child / youth with a disability?
Do you have any contractual or service relationships with any of the organizations below?
LACL
School District
MCFD
CLBC
When would you be ready to provide respite supports?
Do you want to share any other information you would like us to know about?
Click SEND to submit your application.
Head Office:
23535 - 44th Avenue
Langley, BC, V2Z 2V2
Office Hours:
8:00 am to 4:00 pm
Monday to Friday
Phone: 604-534-8611
Fax: 604-534-4763
[email protected]
 
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LANGLEY ASSOCIATION
FOR COMMUNITY LIVING