* Indicates Required

    and name you are called by, if applicable.

    and other last name you use, if applicable.

    with area code

    Select N-A if not in the US

    5 digits only

    How YOU are related to your loved one with BPD?

    If you have a second loved one with BPD, please add your relationship with them and their age here.

    How YOU are related to a 2nd loved one with BPD?

    (If Applicable)

    Policy on taking the course with family members

    You may request to take a course with up to 2 family members. Every person needs to apply individually for FC and also reply to our invitation to enroll individually. We can not guarantee that your request will be accommodated as courses are filled first-come, first-serve.

    Please make sure your family members apply as soon as possible and reference your information in their application.

    The following demographic question is used for analysis purposes only and is optional.

    FC Participant Code of Conduct