Autism Awareness Day Survey

Autism Awareness Day

1. Autism Awareness Day

Learn the signs, find a resource, attend a workshop. Resources, information, refreshments and door prizes!

Friday, April 9,2010
10:00 a.m - 3:00 p.m
Parent Resource Center
2334 Gallows Rd
Room 224
Dunn Loring, VA 22027

1. Name

Name

2. phone number

phone number

3. e-mail address

e-mail address

4. Interpreters are available. Please let us know
two weeks in advance if you need any of these services or contact
the PRC at 703-204-3941.

	Yes	No
Do you need an interpreter to attend this workshop?	Interpreters are available. Please let us know two weeks in advance if you need any of these services or contact the PRC at 703-204-3941. Do you need an interpreter to attend this workshop? Yes	No

Please provide a short description of required needs?

1. Autism Awareness Day

1. Name

2. phone number

3. e-mail address

4. Interpreters are available. Please let us know two weeks in advance if you need any of these services or contact the PRC at 703-204-3941.

4. Interpreters are available. Please let us know
two weeks in advance if you need any of these services or contact
the PRC at 703-204-3941.