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Welcome

If your association would like to nominate a local representative and alternate to the DDSB SEAC, please complete the SEAC Association/Member Nomination form(s) below and submit it to: Lisa Wry, Administrative Assistant for Inclusive Student Services, Durham District School Board or lisa.wry@ddsb.ca

Name of Association/Organization

Chapter #

Provincial Association:

Local Organization:

Does your association/organization wish to have representation on the Durham District School Board (DDSB) Special Education Advisory Committee (SEAC)?

Yes

If yes above, who is being nominated for membership as a representative for the SEAC?

Nominee's First Name:

Nominee's Last Name:

Nominee's email address:

Contact Number:

Alternate Contact Number:

Address of Nominee

City:

Postal Code:

The nominee must meet the qualification criteria as follows:

be a Canadian Citizen;
the age of eighteen years;
a resident within the area of jurisdiction of the DDSB;
a public school elector;
not employed by the DDSB.

Briefly describe your association/organization (if you require additional space to describe your association/organization, please attach an additional page)..

Today's Date:

Title of signing authority

Signature of local signing authority

Clear