Canadian Civil Liberties Education Trust Workshop Request Form
Thank you for your interest in CCLET's education programming. To request a Civil Liberties presentation for your classroom, please fill out the following form and we will respond as soon as possible.
* Required
School Name
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Presentation Category
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Elementary
High School
College
University
Newcomer/ESL
CCLA Talk (Professional Development/Community Engagement/Adult Education)
Other:
School Address
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Street Address, City, Province, Postal Code
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Preferred Presentation Date(s)
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If possible, please provide a range of potential presentation dates
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Teacher 1: Name
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Teacher 1: Email address
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Teacher 1: Phone number
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Teacher 1: Course name and grade level
*
e.g. Grade 11 law, Grade 4 social studies etc.
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Teacher 1: Room #
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Teacher 1: Class start time - Class end time
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00:00 - 00:00
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Teacher 1: Approximate Number of Participants
*
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Additional instructions or notes
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Do you wish to request a second presentation on the SAME date?
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Note: If you wish to request additional presentations on a DIFFERENT date, please select "No" below and submit a separate CCLET Workshop Request Form
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No
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