| 
Building Supportive Communities For Individuals Facing Behavioral Challenges |
- REGISTRATION
FORM - |
| *Please fill in ALL of the registration blanks.
This information
will be used for your badge and the Attendee List to be distributed at
the meeting. |
|
|
|
| DIETARY RESTRICTIONS:
Vegetarian
Vegan
No red meat
Kosher
No pork
Other (Specify)
_____________________________________________ |
| Please check the appropriate box(es):
I am planning to attend the State Directors' Forum
on
 Wednesday, May 12, 1:00
PM - 5:00 PM (NASDDDS Members Only).
I am planning to attend the Welcome Reception on
Wednesday, May 12,
2003, 5:30 PM - 7:00 PM.
SELECT THE APPROPRIATE FEE:
Member $250
LDDA $250
Non-member $350 |
| SPECIAL ACCOMMODATIONS:
If you require a special accommodation to facilitate
participation in the presentation session, please indicate below:
Wheelchair Access
Sign Language Interpreter
Braille Documents
Other, please describe below:
|
| The registration fee
for member state agency staff and local developmental disabilities
authorities (LDDA) is $250. The registration fee for all other attendees is $350.) The fee includes
all meeting materials, sessions, morning and afternoon
refreshments, the Wednesday evening Welcome Reception, and the Thursday
luncheon. The registration fee DOES NOT include
hotel registration or transportation to the conference. You may make
your hotel reservation by calling the Sheraton South
Portland Hotel at 207-775-6161. Be sure to indicate that you are attending
the NASDDDS 2004 Mid-Year Meeting. When
making your hotel reservation, please discuss special accommodations
with the hotel staff.
|
National Association of State Directors of Developmental Disabilities
Services
113 Oronoco Street, Alexandria, VA 22314; Tel: 703-683-4202 |