2023-24 In-School Support Request Form

Participant Information

Name*

First Last

Email*

Position*

Please select a grade level or position

School Name*

School Division/Education Authority*

Location*

In-Person
Virtual
Blended

School Address (If in Person)

Street Address Address Line 2 City Postal Code

School Phone*

Are you a divisional catalyst teacher?*

Yes
No

What do you want the presentation to focus on?*

Who is the audience*

Classroom/Students
Multiple Classrooms
School Staff

Time of Event*

Date of Event*

Have you taken Treaty Education previously?*

Yes
No

Does your school have a Treaty Education Kit?*

Yes
No

How did you hear about our In School Support Service?*

E-Newsletter
TRCM Website
Treaty Education Training Session
Manitoba Education
Divisional Information Sharing

Consent

I agree

Please check if you agree that the Treaty Relations Commission of Manitoba (TRCM) and those authorized by the TRCM have the right to record or copy, on/in any written / electronic / visual format, my likeness and / or voice; and to use, exhibit, distribute and reproduce throughout the world (whether by means of any form of television, Internet or any other means now known or unknown) any such reproductions in connection with advertising or promoting the TRCM. For further information, contact Amanda Simard by phoning (204) 770-0881 or by email asimard@trcm.ca

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2023-24 In-School Support Request Form

2023-2024 In-School Support Team

Participant Information