Professional and Specialist Census Form to Support Parent Educators

Professionals and specialists

user-role

First name

Last name

Phone number

Preferred language

Identify field of competency

Neuropsychologist

Optometrist

Special needs teacher

Speach Therapist

Teacher (not licensed to teach in Québec)

Psychologist

Licensed teacher

Tutoring

OtherOther

First name

Last name

Address

City

State/Province

Zip/Postal

Country

E-mail

Phone number

Website

Language(s)

English

French

OtherOther

Summary of services and related fees

THANK YOU

reCAPTCHA

Volunteer needed

ACPEQ is made up of dedicated volunteers who generously contribute their time and talents. Join the team! ACPEQ needs you!

Stay informed about our news

Email