Registration: Working for Change archived webinar 9-21-10

1. Working for Change Using the Power of a Personal Story Webinar Registration

To access the archived recording of Working for Change Using the Power of a Personal Story, please submit the following information. When finished click on the box labeled DONE.

A window will open with the URL/PACER web site address of the Webinar.

Question Title

* 1. Are you a: (Please check all that apply)

Name: *

Company:

Address:

Address 2:

City/Town: *

State: *

ZIP: *

Email Address:

Phone Number:

Question Title

* 2. Which best describes you?

Parent

Professional

Other (please specify)

Question Title

* 3. If you are a parent, does your child(ren) have a disability?

Yes

Registration: Working for Change archived webinar 9-21-10

1. Working for Change Using the Power of a Personal Story Webinar Registration

Question Title

* 1. Are you a: (Please check all that apply)

Question Title

* 2. Which best describes you?

Question Title

* 3. If you are a parent, does your child(ren) have a disability?

Question Title

* 4. Child(ren)'s Date of Birth

Question Title

* 5. Child(ren)'s Disability