All Abilities Welcome Workshop Request Form

Please provide the following information to request an All Abilities Welcome presentation in your community.

Name of your Organization
Contact Person
Mailing Address
City
Province	-- Select -- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Québec Saskatchewan Yukon
Postal Code
Phone	() -
Email
Type of event (i.e., conference, workshop, clinic, other)
Nature of audience (i.e., recreation providers, therapists, students, other)
Proposed presentation date(s)
Anticipated size of audience
Proposed presentation location (city/town, venue)
Key messages or themes which may be relevant to your audience / event:

 

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Printable version

A printable version of this form may be obtained here. Please send / fax completed form to:
	Jason Dunkerley, All Abilities Welcome Coordinator Active Living Alliance for Canadians with a Disability 104-720 Belfast Road Ottawa ON, K1G 0Z5 Tel.: 1-800-771-0663 or (613) 244-0052 ext 25 Fax: (613) 244-4857 Email: allabilitieswelcome@ala.ca