DATE OF PRESENTATION: _______________________________________

PROGRAMME TITLE: ____________________________________________

NAME OF SCHOOL: _____________________________________________

TEACHER: _____________________________________________________

COMMENTS: ___________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

Please return to either:

Pat (Patricia) Crocker 1004-45 Pond Mills Road London, ON N5Z 4W5 519.680.0357

Wendy Percival 519.456.6628