HAMILTON-WENTWORTH CATHOLIC DISTRICT SCHOOL BOARD ONLINE BOOKING REQUEST FORM

To request a school screening, please complete in detail and submit the online booking request form below.

Name of School*

Contact Name*

Telephone Number*

Email

Preferred Date of Screening*

Preferred Time of Screening*
[time TimeOfScreening time-format:HH:mm]

Select Grade for Screening*

Number of Students Screened (Approx.)*

Preferred Method of Contact*