Make It Take It Registration
Page 1 Form
Thank you for your interest in our Make It Take It Workshops.
After completing the registration, you will receive two reminder emails: (1) about a week and (2) about a day before each event for which you have registered.
Should you have any questions, please let us know by sending us an email (hands@iupui.edu) or call us (317) 274-8162 option "0"
We look forward to seeing you at the events!
1.
Events for which you would like to register:
MITI: Visual Schedules on January 27, 2010 (5:30pm - 7:30pm) at PB
MITI: Beyond the Schedules on February 17, 2010 (5:30pm - 7:30pm) at PB
MITI: Social Skills on March 17, 2010 (5:30pm - 7:30pm) at PB
MITI: Collaborative Tools for Effective Advocacy on April 21, 2010 (5:30pm - 7:30pm) at Clarian North
2.
Please provide your contact information.
Name
County (for Indiana residents)
-- Please Select --
Adams
Allen
Bartholomew
Benton
Blackford
Boone
Brown
Carroll
Cass
Clark
Clay
Clinton
Crawford
Daviess
Dearborn
Decatur
De Kalb
Delaware
Dubois
Elkhart
Fayette
Floyd
Fountain
Franklin
Fulton
Gibson
Grant
Greene
Hamilton
Hancock
Harrison
Hendricks
Henry
Howard
Huntington
Jackson
Jasper
Jay
Jefferson
Jennings
Johnson
Knox
Kosciusko
Lagrange
Lake
La Porte
Lawrence
Madison
Marion
Marshall
Martin
Miami
Monroe
Montgomery
Morgan
Newton
Noble
Ohio
Orange
Owen
Parke
Perry
Pike
Porter
Posey
Pulaski
Putnam
Randolph
Ripley
Rush
St. Joseph
Scott
Shelby
Spencer
Starke
Steuben
Sullivan
Switzerland
Tippecanoe
Tipton
Union
Vanderburgh
Vermillion
Vigo
Wabash
Warren
Warrick
Washington
Wayne
Wells
White
Whitley
Email Address
Phone Number
Optional:
Would you want to join our listserv to receive event updates, newsletters, and other helpful information via email?
Your information is
not
shared with a third party.
-- Please Select --
Yes
No
Already a listserv member
3.
How many people will attend?
1
2
Other
4.
What is your role?
Parent/Caregiver
School Personnel (teacher, IA, etc)
Medical Professional
Student
Other
5.
How did you learn about this event?
Online Surveys
powered by SurveyGizmo