Accessibility Services Workshop Request Form Feb 13, 2020 Contact informationName: First Last Email: * Required Phone: * RequiredDepartment/college/faculty/officially recognized student group or campus organization: * Required Preferred facilitator(s) or Accessibility Services staff member(s): * Required Number of facilitators requested: * Required Outreach typePlease indicate the type of outreach you require: * Required Workshop Audio-visual/PowerPoint presentation Tabling or kiosk participation Panel discussion Q&A session 15-minute introduction to Accessibility Services programs & services TopicPlease select all that apply: * Required Select All Introduction to services and programs offered by Accessibility Services Orientation programming for incoming students Navigating disability on campus Creating accessible environments Learning skills Other If you selected other, please specify: * Required Intended audienceHow many participants will there be, approximately? * Required Who is the target audience? * Required Undergraduate students Graduate students Prospective students International students U of T staff U of T faculty U of T student staff External community If you selected external community, please specify: * Required Please list information about the group’s discipline or program, and any other relevant information: * RequiredWill this workshop occur during a lecture/course (in-class)? * Required Yes No If you selected yes, which course? Will the presentation be recorded and/or used for future screening purposes (ie. posted on Quercus)? * Required Yes No For our tracking purposes, Accessibility Services requires an aggregate number of students in attendance. Are you able to provide us with this information? * Required Yes, we can send this to you prior to the workshop or soon after. No, but we will have a copy of the attendance sheet there which you can take at the end. Date and timeWhat are the preferred date(s) and time(s) for this workshop? Please list a few options, if possible. * RequiredIf you selected yes, please indicate an approximate number of items: * Required Location: * Required Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code What is the set-up of the location? * Required Tiered (sloped-floor) classroom(s) or lecture theatre Non-tiered classrooms Will computer/AV access be provided? * Required Yes No, not applicable Will you require Accessibility Services resources/info cards/brochures? * Required Yes No, not applicable Will breakfast/lunch/refreshments be provided? * Required Yes No, not applicable How did you hear about workshops provided by Accessibility Services? * Required If there is anything else you would like to let us know, please include it below: * RequiredFreedom of Information and Protection of Privacy Act * Required I agree to the privacy policy.The University of Toronto respects your privacy. Personal information that you choose to provide voluntarily to the University is collected pursuant to section 2(14) of the University of Toronto Act, 1971. It is collected for the purpose(s) of program administration. At all times it will be protected in accordance with the Freedom of Information and Protection of Privacy Act. If you have questions, please contact accessibility.services@utoronto.ca.
