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Accessibility Services Workshop Request Form

"*" indicates required fields

Contact information

Name:

Outreach type

Please indicate the type of outreach you require: * Required

Topic

Please select all that apply: * Required

Intended audience

Who is the target audience? * Required
Will this workshop occur during a lecture/course (in-class)? * Required
Will the presentation be recorded and/or used for future screening purposes (ie. posted on Quercus)? * Required
For our tracking purposes, Accessibility Services requires an aggregate number of students in attendance. Are you able to provide us with this information? * Required

Date and time

Location: * Required
What is the set-up of the location? * Required

Will computer/AV access be provided? * Required
Will you require Accessibility Services resources/info cards/brochures? * Required
Will breakfast/lunch/refreshments be provided? * Required
Freedom of Information and Protection of Privacy Act * Required