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Awards and Retirement Celebration (SEA Event) Thurs May 28 – SAVE THE DATE

“A Moment In Time”

Thursday May 28 @ 5:00 pm 9:30 pm

3410 Semenyk Court
Mississauga, ON L5C 4P8
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REGISTRATION OPENING SOON

First Name

Last Name

Your School / Worksite

Your Non-Board Email

ETFO Number

OCT Number

PDSB Employee Number

Is this your 1st (first) time attending a PETL event?

How many years have you been a PETL member (Permanent Hire with the PDSB)?

Dinner RSVP

Please indicate the number of years you have been in the teaching profession, in any board, including part-time and occasional teaching. Pins will ONLY be awarded to members whose years of service MATCH one of the designated years below. They are not given retroactively.

Ticket Type

Number of Complimentary Tickets

Number of Tickets Requiring Payment

Total Number of All Tickets

Total Amount Payable (If $0 type $0 – zero)

Payment Acknowledgement

Dietary Requirements (i.e., Anaphylaxis/Allergy to , Gluten-free, Halal, Kosher, Lactose Intolerant, Pescatarian, No Dairy/Beef/Pork, Vegetarian, Vegan)

Accommodations (i.e., Closed Captioning Required)

Self Identification

Racialized Person (Please Specify)*

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