Professional Development Workshop Registration Form

1

Name

First Name

Last Name

2

School name

3

E-mail

4

Phone Number

Area Code

Phone Number

5

Which SSV District are you a part of?

6

What type of professional development are you looking for?

Individual

School staff < 5 people

School staff >5 people

SSV District PE team

7

When would you like to run your session? Feel free to provide up to 3 date options. Format is DD/MM/YYYY

8

Do you have a additional date options?

YESNO

9

Second date option:Format is DD/MM/YYYY

10

Do you have a third date option?

YESNO

11

Third date option. Format is DD/MM/YYYY

12

What time throughout the day best suits you?

Before school - 8:00am - 9:00am

Morning session - 9:00am - 11:00am

Midday session - 11:30am - 1:30pm

Afternoon session - 2:30pm - 4:30pm

After school 3:45pm - 5:45pm

Other?

13

If another time, when?

14

Desired OutcomesAre you interested in anything in particular to help us plan for delivery? I.e Fundamentals of hockey skills, umpiring, game rules, positioning on teams etc.

15

What is your experience with hockey?

16

Additional comments