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Sexual Health Educator Workshop - Registration Form

Sexual Health Workshop Image

Your Name: (Required)

Your E-Mail Address: (Required)

School Name: (Required)

Contact Phone Number: (Required)

Please check all that apply: (Required)

I have attended an educator workshop within the past 2 years.
A Public Health Nurse provided an in-class session in 2007/2008.
I would like an in-class session provided by the Public Health Nurse this school year.
I would like to co-teach an in-class session with the Public Health Nurse this year.
I will teach the sexual health program in my class this year.
I would like to receive future educator manual updates.

Please check the workshop you are registering for: (Required)

Wednesday, October 1, 2008 at the Essex Civic Center, 360 Fairview Ave. West, Suite 215, Essex, ON 4:30 p.m. - 6:00 p.m.
Thursday, October 2, 2008 at the Windsor-Essex, 1005 Ouellette Avenue, Windsor, ON 4:30 p.m. - 6:00 p.m.

Please note that the Public Health Nurse may not be able to accommodate all teaching requests. Priority may be given to those teachers who attend the 2008/2009 workshop. The Public Health Nuse will contact you regarding your request following the workshop.

If you have any questions, please contact Janet Ulicny at 519-258-2146 extension 1230.

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