Campus O and M Event Pre-Session

Campus O&M Event Pre-Session
Online learning programs are for students who qualify for APSEA services. Registration must be completed by their APSEA Education Support Teacher (EST).
Education Support Teacher Name:*

First NameLast Name
Education Support Teacher Email Address:*
example@example.com
Session Selection
Please select the session to attend:*

Wednesday, January 7Wednesday, January 14
Student Information
Student Name:*

First NameLast Name
Student Email Address:
example@example.com
Grade:*
If Other, please specify grade:*
City/Town:*
Province:*
Parent/Guardian Information
Parent/Guardian Name:*

First NameLast Name
Parent/Guardian Email Address:*
example@example.com
School Information
School District/Regional Centre for Education*
School Name:*
School Team Contact Name:*
School Team Email Address:*
example@example.com
School Team Member Role:*
If Other, please specify:*
In Class Support
Full Name:

First NameLast Name
Email Address:
example@example.com
Job Title:
If Other, Please Specify:*
Informed Consent for Student Participation for Online Programs:*

Uploaded to the APSEA Database
Permission to Record or Photograph:*

Uploaded to the APSEA Database
Level of permission to record or photograph:*
Note: By completing this registration you are agreeing that the applicable required permission forms have been uploaded to the APSEA database.
Feedback
How did you hear about this program?*
If Other for how you found out about this program, please specify
Should be Empty:

Campus O&M Event Pre-Session