VP Seminar Questionnaire

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Visual Phonics Seminar Questionnaire

Seminar Information:

* Indicates required field

Training Start Date and Time: *

Workshop Type: *

In-Person Online

Personal Information:

Name *

First

Last

Email *

Phone Number *

Address

(not required, but please indicate City & State) *

Line 1

Line 2

City

State

Zip Code

Country

Questionnaire:

1. How did you first hear about Visual Phonics? *

people at work friend service club* TV or radio* publication* website* ESC staff development catalog district/program-required staff development other

If other, explain here: *

*Name of service club, TV/radio program, publication, or website *

2. Please state briefly you reasons for attending this seminar *

3. I am a/an... (check all that apply to you) *

preschool teacher kindergarten teacher first grade teacher second grade teacher third grade teacher upper elementary teacher (grades 4-5) middle school teacher (grades 6-8) high school teacher (grades 9-12) special education teacher deaf educator speech language pathologist, therapist, or assistant reading/literacy teacher or tutor ESL/bilingual educator school or program administrator parent other

If other, explain here: *

Acknowledgement:

To receive a Visual Phonics Certificate of workshop completion, I acknowledge that I will need to:

attend all workshop sessions since the workshop will not be recorded.
have the video on my device turned on for all of the workshop sessions.
either complete a video submission or participate in a Live Review Session.

Additionally, I acknowledge that each participant will need to be in front of a device for workshop participation
(i.e. one device per participant).

Check to Proceed: *

I agree

Do you have additional comments? *

Submit

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