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Leap Junction - Intake Form
If you are interested in accessing the services that Leap Junction at Fanshawe College has to offer, please fill out this form and we will get back to you to schedule an appointment as quickly as possible.
Name *
Your answer
Email *
Your answer
Primary Phone Number *
Your answer
Student Number
If applicable.
Your answer
What is your area of study?
If applicable.
Your answer
Are you a: *
Are you between the ages of 18-29?
Do you agree to be contacted by the Leap Junction team for Entrepreneurial Services? *
How did you hear about Leap Junction?
Your answer
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