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 Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Province Email Phone Level:* 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 Training Closed Training Online Training Training Agency or School Venue Address Street Address Address Line 2 City Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Province Postal Code Basic Instructor Practicum Supervisor Advanced Instructor Estimated # Participants Please enter a number from 1 to 100. Starting Date MonthMonth 1 2 3 4 5 6 7 8 9 10 11 12 DayDay 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 YearYear 2026 2025 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Ending Date MonthMonth 1 2 3 4 5 6 7 8 9 10 11 12 DayDay 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 YearYear 2026 2025 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Length 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.
