Registration for
Parent/Advocate Network on Inclusive Education

1. First Name :

2. Family Name :

3. Email Address :

4. Telephone # :

5. Mailing Address :

6. Your Status :

 a. Parent -

 b. Family Member -

 c. Friend -

 d. Self-Advocate -

7. Key Interests :

7.1

7.2

7.3

8. How can you support our work?

 a. By getting Involved: -

 b. By supporting our work financially: -

 c. Other: -

9. Comment:

Note:

As a member of our network you will receive emails and messages concerning inclusive education. We will respect privacy standards and will not share your name or email address with third parties.

To have your name withdrawn from our network at any time – send an email to inclusiveeducationcanada@gmail.com

Welcome to our Network.