Implementing Connecticut's Revised Guidelines for Identifying Children with Learning Disabilities

1. Default Section

1. Which session would you like to attend (all sessions will be from 9:00am to 12:30pm)

Please note: Sessions B, E, & F are now closed due to overenrollment.

Which session would you like to attend (all sessions will be from 9:00am to 12:30pm) Please note: Sessions B, E, & F are now closed due to overenrollment. Session D: Thursday, December 10, 2009, Crowne Plaza Hotel, Southbury, CT

Please note: REGISTRATION DEADLINE is 2 WEEKS PRIOR TO EACH SESSION

2. Team Member # 1 -Director of Special Education (or designee)

Team Member # 1 -Director of Special Education (or designee) Name:
Home Address:
City:
State:
Zip Code:
Home Phone Number:
Work Phone Number:
SERC Member #:
Email Address:
Position/Title:
School/Organization:

3. Team Member # 2 - General Education Elementary Teacher

Team Member # 2 - General Education Elementary Teacher Name:
Home Address:
City:
State:
Zip Code:
Home Phone Number:
Work Phone Number:
SERC Member #:
Email Address:
Position/Title:
School/Organization:

4. Team Member # 3 - Special Education Elementary Teacher

Team Member # 3 - Special Education Elementary Teacher Name:
Home Address:
City:
State:
Zip Code:
Home Phone Number:
Work Phone Number:
SERC Member #:
Email Address:
Position/Title:
School/Organization:

5. Team Member # 4 - School Psychologist

Team Member # 4 - School Psychologist Name:
Home Address:
City:
State:
Zip Code:
Home Phone Number:
Work Phone Number:
SERC Member #:
Email Address:
Position/Title:
School/Organization:

6. Team Member # 5 - Additional Team Member

Team Member # 5 - Additional Team Member Name:
Home Address:
City:
State:
Zip Code:
Home Phone Number:
Work Phone Number:
SERC Member #:
Email Address:
Position/Title:
School/Organization:

7. Team Member # 6 - Additional Team Member

Team Member # 6 - Additional Team Member Name:
Home Address:
City:
State:
Zip Code:
Home Phone Number:
Work Phone Number:
SERC Member #:
Email Address:
Position/Title:
School/Organization:

8. If a special accommodation is needed for participation, please specify:

If a special accommodation is needed for participation, please specify:

Applicants will receive written confirmation regarding participation shortly after the registration closing date.

For Registration Questions, please contact:
Angel Davis, Educational Service Specialist, at (860)632-1485, ext. 293, or davis@ctserc.org