Basic Intensive, Basic Practicum, Advanced Intensive, Advanced Practicum Approval Contact Information :* First Last Organizer ( Materials will be shipped to this address )Address Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Email PhoneLevel:* Basic Intensive Basic Practicum Advanced Intensive Advanced Practicum Certification Practicum Supervisor – Preparation Phase Practicum Supervisor Level 1 Practicum Supervisor Endorsement Instructor 1 Instructor Endorsement Intensive Training Information*Open TrainingClosed TrainingOnline TrainingTraining Agency or School Venue Address Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Basic Instructor Practicum Supervisor Advanced Instructor Estimated # ParticipantsPlease enter a number from 1 to 100.Starting DateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Ending DateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Length of Training and extra information ( if needed )Options for Training under WGI revised guidelines 3 or 4 consecutive days ( based on the number of participants ) 2 days followed by 2 days with 1-2 weeks in between 3 hour consecutive weekly. sessions over a period of two months with learning experiences in between sessions 4 one day sessions over a month with learning experiences in between sessions 4 Professional Development Days/Continuing Education days over one year. This option is for closed training and is offered to supports schools, organizations and companies. Between the 4 sessions would mirror basic practicum in hours and content and at the end of the year participants would be ready for Advanced Intensive. * With organized learning experiences between sessions.Option for 3 consecutive days and 21 hours. MM slash DD slash YYYY Starting Date (Day 1 of 3) More information if needed.Practicum Supervisor (If training is closed and has 17-20 Participants) Agreement : I will follow what is outlined in the GLASSER CANADA & WGI Policies and Procedures Manual (PPM), and am aware of the current acceptable intensive training forms and their terms.* I Agree* i certify that the scheduling of the training will be in accordance with the PPM.
