Behavioural Science Programs George Brown College George Brown – Toronto City College Behavioural Science Technology Program and Autism and Behavioural Science Placement Information Sheet Note: The electronic version of this form can be found at the Placement Providers link at www.gbrownc.on.ca/~amcnamar. Name: _____________________________ Organization: ___________________________ Address: ________________________________________________________________________ Postal Code: _________________________ Best time to contact: ______________________ Phone: __________ Email: __________________________ Fax: ___________ Is the placement accessible by public transportation? Yes / No If so, which is the closest station / stop? ________________________________________________ Client Population Served: ___________________________________________________________ Type(s) of Service Provided (Check all that apply): Residential _____ Day Program _____ Outreach _____ Educational _____ Vocational _____ Rehabilitation _____ Treatment _____ Behavioural Science Technology Program Student supervision will be provided by a(n) ________________________ (Profession / Title) Placements for First Year students are for four (4) hours per week for 14 weeks from January 9, 2006 to April 21, 2006 with an Intersession break from February 27 – March 3, 2006. Placements for Second and Third Year students are 7-week (37.5 hrs per week) block placements. The dates for these placements are: Winter Semester I March 6 – April 21, 2006 Winter Semester II April 24 – June 10, 2006 (Intensive Students Only) Number of students you can support: Winter Semester I Winter Semester II First Year students (4 hours per week for 14 weeks) Second Year / Intensive Program students (37.5 hours per week for 7-weeks) Third Year / Intensive Program students (37.5 hours per week for 7-weeks) Autism and Behavioural Science Program The second Field Placement is a 7-week (37.5 hrs per week) block placement. The dates for this placement are March 6 to April 22, 2006. Number of students you can support: Winter Semester Second Placement (37.5 hours per week for 7-weeks) Thank you for participating in the George Brown College Behavioural Science programs! Behavioural Science Programs George Brown College Please provide a brief description of the placement including the hours of work, learning experiences, and activities that would be relevant to the placement. ______________________________________________________________________________________________ ______________________________________________________________________________________________ Other assets / needs relevant to this placement: ______________________________________________________________________________________________ ______________________________________________________________________________________________ Please fax your response to 416-415-2646, Attention: Andrew McNamara or via email to amcnamar@gbrownc.on.ca Thank you for participating in the George Brown College Behavioural Science programs!