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: * RequiredPreferred facilitator(s) or Accessibility Services staff member(s): * RequiredNumber of facilitators requested: * RequiredOutreach typePlease indicate the type of outreach you require: * RequiredWorkshopAudio-visual/PowerPoint presentationTabling or kiosk participationPanel discussionQ&A session15-minute introduction to Accessibility Services programs & servicesTopicPlease 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: * RequiredIntended audienceHow many participants will there be, approximately? * RequiredWho 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: * RequiredPlease list information about the group’s discipline or program, and any other relevant information: * RequiredWill this workshop occur during a lecture/course (in-class)? * RequiredYesNoIf you selected yes, which course?Will the presentation be recorded and/or used for future screening purposes (ie. posted on Quercus)? * RequiredYesNoFor our tracking purposes, Accessibility Services requires an aggregate number of students in attendance. Are you able to provide us with this information? * RequiredYes, 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: * RequiredLocation: * 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? * RequiredTiered (sloped-floor) classroom(s) or lecture theatreNon-tiered classroomsWill computer/AV access be provided? * RequiredYesNo, not applicableWill you require Accessibility Services resources/info cards/brochures? * RequiredYesNo, not applicableWill breakfast/lunch/refreshments be provided? * RequiredYesNo, not applicableHow did you hear about workshops provided by Accessibility Services? * RequiredIf 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.
