CNIB Outreach Presentation Request

Thank you for your interest in receiving an awareness presentation from CNIB. Our primary goal is to make communities more accessible and inclusive for people living with blindness or low vision through fostering awareness among our audiences.

Please let us know what type of presentation you are looking for by completing the request form below. Once we have received your completed form, one of our team members will be in touch shortly to discuss further and make arrangements.

Details of the Contact at the Organization

Name of group, school, business or organization:

First Name:

Last Name:

Phone:

Email:

Region of Contact:

Topic Selection

Select all the topics of interest to your audience:

Accessibility/InclusionAccessible Workplace PresentationAssistive TechnologyBlindness EtiquetteBraille LiteracyCNIB Programs & ServicesInclusive School PresentationUnsureWhite Canes & Guide DogsOther

If other, please write down the topic:

Additional Details of the School

School Board:

Grade of students (if applicable):

Details of Presentation

Date of the event (DD/MM/YYYY) - if known:

Time of the Event - if known:

Desired length of presentation (expressed in minutes):

Method of Delivery:

In-Person Event Details

Address of Location (Include Postal Code):

City:

Province:

Audience (e.g., student, staff, assembly, etc.,.):

Size of audience:

Edit section title

Will there be other presenters?

Focus of presentation(1000 Characters):

How did you hear about our outreach presentations?

DISCLAIMER

Please read the following disclaimer carefully prior to submitting your registration.

I understand that all personal information which is part of this registration will be collected, used, disclosed or retained in accordance with CNIB’s Privacy Policy.

I have read, understood and agree to the above declaration.

Yes

Contact Information

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