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Safety Plan Workshop (Mon Jan 26 – HSW Committee)

First Name

Last Name

School / Worksite

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)?

Accommodations (i.e., Closed Captioning Required)

Self Identification

Racialized Person (Please Specify)*

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