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Workshop Request – Education Grant
NCCM Workshop Request Form - Ministry of Education Grant
Please fill out this form in order for us to be able to organize your requested workshop.
Name of Requesting Organization
*
Contact Name
*
First
Last
Address
*
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Work Phone
*
Cell Phone
Email
*
Choose Your Workshop
*
Educators: A Teachable Moment About Islamophobia (1.5-2.5 hours)
Students: Say Salam - Islamophobia and Bystander Intervention (45-60 min)
Students: Representation in the Media (45-60 min)
Students: Fake News- How to determine what is real and what is not (45-60 min)
Suggested workshop dates:
*
MM slash DD slash YYYY
MM slash DD slash YYYY
MM slash DD slash YYYY
Time of Workshop
*
:
Hours
Minutes
AM
PM
AM/PM
Location of Workshop
*
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Anticipated Size of Audience
*
Please provide additional information about the audience. (For teachers, which grade levels they teach; for students, indicate to which grade(s) they belong).
*
What are some questions you hope this workshop will answer?
Do you require any special accommodations to ensure full participation from audience members?
Is this workshop part of a larger event/conference?
*
Yes
No
If yes, provide details on Program Segments and Speakers:
If no, would you like to take advantage of our $5/person food subsidy?*
Yes
No
*subject to availability
Receive NCCM Community Updates
Yes please!
Check the box above to sign up to NCCM's email community and receive education news, information on upcoming workshops & events, community updates and more. You can unsubscribe at any time.
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