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.
School Name *
Your answer
Type of School *
School Address *
Street Address, City, Province, Postal Code
Your answer
Preferred Presentation Date(s) *
If possible, please provide a range of potential presentation dates
Your answer
Teacher 1: Name *
Your answer
Teacher 1: Email address *
Your answer
Teacher 1: Phone number
Your answer
Teacher 1: Course name and grade level *
e.g. Grade 11 law, Grade 4 social studies etc.
Your answer
Teacher 1: Room #
Your answer
Teacher 1: Class start time - Class end time *
00:00 - 00:00
Your answer
Teacher 1: Approximate Number of Students *
Your answer
Additional instructions or notes
Your answer
Do you wish to request a second presentation on the SAME date? *
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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