Workshop: Making a Difference - May 27, 2019 4:30 p.m. - 7:00 p.m.

Making a Difference - supporting positive behaviour in elementary schools

MAIN SITE: North Grenville D. H. S., Kemptville

REMOTE SITE: Viscount Alexander P. S., Cornwall

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* 1. Name: (Last, First)

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* 2. Email address:

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* 3. Telephone number:

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* 4. Your worksite:

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* 5. Workshop Location

Main Site: North Grenville D.H.S.

Remote Site: Viscount Alexander P. S.

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* 6. ACCESSIBILITY NEEDS: check all that apply

Attendant

Headphone/FM System

Accessible Parking

Alternative Media/print

Mobility Challenges

Raised Toilet Seat

Service Animal

Partial Accessibility (grab bars)

Wheelchair/Scooter or assistance devices

Environmental Allergies (please specify below)

Food Allergies - shellfish

Food Allergies - peanuts

Food Allergies - tree nuts

Food Allergies - gluten

Food Allergies - other - describe below

Other (please specify)

Question Title

* 7. ACCESSIBILITY NEEDS: check all that apply

Attendant

Headphone/FM System

Accessible Parking

Alternative Media/print

Mobility Challenges

Raised Toilet Seat

Service Animal

Partial Accessibility (grab bars)

Wheelchair/Scooter or assistance devices

Environmental Allergies (please specify below)

Food Allergies - shellfish

Food Allergies - peanuts

Food Allergies - tree nuts

Food Allergies - gluten

Food Allergies - other - describe below

Other (please specify)

Question Title

* 1. Name: (Last, First)

Question Title

* 2. Email address:

Question Title

* 3. Telephone number:

Question Title

* 4. Your worksite:

Question Title

* 5. Workshop Location

Question Title

* 6. ACCESSIBILITY NEEDS: check all that apply

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* 7. ACCESSIBILITY NEEDS: check all that apply

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* 8. Other information