Thank you for your interest in accès:succès, L’Annexe’s six-week workshop series, in partnership with the Access Centre for Students with Disabilities.

Please complete the information below and we will be in touch shortly!


accès:succès at Concordia
1. Full Name (participant):
2. Concordia student ID:
3. Preferred Name:
4. Pronoun, if you would like to share:
5. E-mail (participant):
6. Date of Birth (participant):
/ /
7. Home address
(street, city, postal code)
8. Phone number:
9. Preferred method of communication:
10. Please check each workshop date below to confirm that you are available to attend:
11. If you have any concerns about your availability, please list them here:
12. Do you have dietary restrictions or severe allergies to any foods?
13. Do you have any access needs you would like us to know about in advance?
14. What do you hope to get out of this workshop series?
15. Is there anything else you would like us to know about you?
16. Do you have questions for us?
17. Thank you for sharing this information with us so that we can document participation in our program. All information will be kept confidential and only shared between L’Annexe and the Concordia Access Centre:
Please check the boxes below to indicate your understanding: