COUNSELOR TRAINING

PLEASE COMPLETE TO GAIN ACCESS TO OUR "2020-2021 TEXAS BULLYING & CYBERBULLYING" ELEMENTARY SCHOOL PRESENTATION MATERIALS

YOUR INFORMATION

Name *

First

Last

Email *

Confirm Email

Contact Phone Number

SCHOOL INFORMATION

School Name *

School District *

(enter N/A if not applicable)

Zip Code *

What outcome(s) would you like to see by using the DLF 2020-2021 Texas Bullying & Cyberbullying elementary school presentation materials (check all that apply) *

Awareness and understanding of Cyberbullying
Awareness and understanding of David's Law
Change in behavior

Does your campus currently have an anti-bullying program and/or club? *

Please let us know the number of students by grade level, and number of staff/faculty on your campus.

Number of Students *

Number of Staff/Faculty on Campus *

AGREEMENT

I confirm my attendance of the DLF 2020-2021 Texas Bullying & Cyberbullying elementary school presentation training. I agree the presentation training materials are to be used on my campus only. I will refer other counselors, not on my campus, to attend the training to gain access to the materials. *

I agree
I do not agree

Date of training attended

Upon submission of this form our office will confirm your attendance at one of our training session in order to provide you access to the presentation materials.

Phone