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Certificate of Honour for frontline healthcare workers / C
ertificat d'honneur pour des professionnels de la santé de première ligne
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* Indicates required question
Full name / Nom
*
Your answer
Address / Adresse
*
Your answer
E-mail address / Adresse c
ourriel
*
Your answer
Telephone number /
Numéro de téléphone
Your answer
Job position during the pandemic / Poste pendant la pandémie
*
Your answer
Time period working as front-line healthcare worker
/ Période de travail en tant que travailleur de la santé de première ligne
*
Your answer
Name & contact information of supervisor /
Nom et coordonnées du superviseur
*
Your answer
Preferred language / Langue préférée
*
English
Français
Notes / Remarques
Your answer
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