For Open Participants

Please note SurveyMonkey is a cloud-based tool located outside of Canada. If you do not consent to sharing your personal information here, you may email your responses to edtech@uvic.ca. Giving your name here means that information and any other information you choose to share on this form will be disclosed and stored on SurveyMonkey's servers. Privacy legislation in B.C. requires we inform you of this and obtain your consent to this arrangement. This consent will be valid from the date you submit this form. In this form are options provide your contact information for registration to a video collaboration event, where your data will be stored privately.

You will be contacted with next steps to participate should room be available and enough time be available to process your request. We recommend that open learners register by 10am PST on Wednesday, March 31, in order to be registered, although we will do our best to attend to any registration requests after this time.

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* 1. Name (First and Last)

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* 2. What city, province/state, and country are you from?

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* 3. Email Address (this is where we will send you information on how to participate)

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* 4. If it is not obvious based on your email address that you are affiliated with a reputable organization (e.g., a school or otherwise recognizable email address), please provide other information that may verify that you are not a troll. Otherwise, we might not be able to admit you to the event or we may contact you for further information or to invite you to a prescreen event).

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* 5. May we use your email address to contact you regarding future information or formal learning opportunities via EdTech @ UVic?

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* 6. Twitter Handle (provide only if you are comfortable with us tweeting at you or listing your handle publicly)

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* 7. Position

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* 8. Organization (e.g., school district, university, independent, etc.)

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* 9. Subject areas, topics, or issues of interest (or expertise) as it pertains to education or educational technology specifically.

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* 10. Level of education of interest

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* 11. Requested topics for future open events

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