Course Registration

All the information must be completed on the form below before submitting. Incomplete forms will cause a delay in registration.

First Name:		Last Name:
City:		State:
Ethnicity: White Black/African American Hispanic Native American Asian Other		You are: Parent of a child with a disability Person with a disability Family member of a child with a disability Educator Other
Age of Child:
What is the disability of the child/person with a disability?
Which course would you like to register for? IDEA 2004 Making Your Case Partners in Education
Your Email Address: