Learning Through Loss Workshop & Training Expression Interest Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Are you interested in having Learning Through Loss deliver a workshop or training for your school or agency?Please complete this expression of interest form and we'll follow up with you to coordinate arrangements. Completion of this form does not obligate you to proceed with programming.

Email *

First and Last Name

School or Agency Name

Email Address

I grant permission for LTL to contact me by email

Yes

Clear selection

Phone number (xxx) xxx-xxxx

Mailing Address: Please include your municipality (i.e. Victoria, Oak Bay, Saanich, Langford etc.)

Please note that as a registered Canadian Charity, Learning Through Loss programs and services are priced based on the actual cost of delivery. If budget or financial hardship are issues, there may be funding available. Please contact info@learningthroughloss.org to discuss.

Which Learning Through Loss Programs are you interested in? (Please check all that apply).

Good Grief for Youth Workshop (60-90 minutes)

Supporting Youth Through Loss and Grief for Educators (60-90 minutes)

Supporting Youth Through Loss and Grief for Parents & Guardians (60-90 minutes)

Supporting Youth Through Loss & Grief Training for Training for Educators (3 hours)

Supporting Youth Through Loss & Grief Training for Counsellors (7 hours)

Learning Through Loss Peer-Support Counselling Program (8 - 1.5 sessions)

When are you interested in presenting this (these) workshops? Please provide preferred dates and times, specific to the workshops you've selected above.

For Good Grief Workshops for Youth Workshops. Please provide the grade level for the students

Grade 7

Grade 8

Grade 9

Grade 10

Grade 11

Grade 12

Post-Secondary

When are you interested in holding this (these) workshop(s)? (Dates/times)

When is the best date/time for us to follow up with you?

Thank you for taking the time to complete this expression of interest. A member of our team will follow up within 5 business days or based on the preferences you stated above.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Kathryn Dafos. Report Abuse

Forms