Notice with Respect to Collection of Personal Information
The information on this form is collected under the authority of the Municipal Freedom of Information and Protection of Privacy Act and the Freedom of Information and Protection of Privacy Act. This information will be used for the delivery of Wellington County Learning Centre programs and services; and the maintenance of related databases, registries and related research, in compliance with legal and regulatory requirements. Any questions about the collection of this information should be addressed to Ken Harvey, Circles Coordinator at 1.800.265.7294 x 3062.
Support System Assessment
Mental Health Assessment
Rosenberg Self-Esteem Survey
Directions: Please choose the option which best matches your agreement with each statement below.