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* 1. Name:

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* 2. Email address:

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* 3. Province or Territories of home address:

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* 4. Years of OT work in Canada?

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* 5. Do you have the following experience?

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* 6. Provide details of your work experience from the last 5 years.

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* 7. Have you done work to oppose oppression (e.g., racism) by advocating for changes in their political, economic, or social lives?

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* 8. Do you have experience  writing exam questions or involved in high-stake examinations?

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* 9. Given that the NOTCE is a case based exam, provide initial ideas of scenarios/types of clients that you foresee incorporating into the NOTCE which would address Domains C and D. 

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* 10. Do you need accommodations to fully participate and accomplish this task? If yes, please describe:

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* 11. Are you able to complete all NOTCE item writing tasks within the specified timelines, as described in the e-mail?

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* 12. Optional: How do you identify yourself? (Race, Gender, Sexual Orientation)

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