Form Builder

Pronoun

Title

First Name

Last Name

Phone Number

Personal Email

Some school districts have strong firewalls. Please include a personal e-mail as a backup.

Grade Level(s)

Number of Students

Room Number

School Name

School Street Address

City

Province

Postal Code

Tell us how this workshop will support your classroom teaching.

Preferred Date(s) and Time of Day

Please list them in order of preference.

Special Notes

Please let us know about your school's visitor procedure, parking availability, accessibility, etc.

AV Requirements

Do you have access to a document reader/camera and projector (e.g. InFocus)?

Yes, I have access to a document reader/camera and projector (e.g. InFocus)
No, I do not have access to a document reader/camera and projector (e.g. InFocus)