Welcome! We are so pleased that you have decided to visit our school site. We appreciate receiving the information below so that we can tailor your visit to suit your group's individual needs and interests.

* 1. Name:

* 2. Position supporting children:

* 3. Affiliation (Name of school, district office, university, etc)

* 4. Phone:

* 5. Email:

* 6. You may focus your visit at CHIME by choosing up to three topics from the menu below. Please prioritize your choices by numbering their boxes:

Please take a moment to indicate your level of expertise in each of the following areas by marking the
appropriate number. ( 1 indicates the least amount of knowledge, 10 the most.)

* 7. I know how to organize a school for inclusive support of students with disabilities.

* 8. I understand how teachers must collaborate in order to accommodate the needs of all students in the General Education classroom.