Copy of NEW! February 2010 Teleconference Registration

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1. Thank you for your interest in this teleconference!

This institute is entitled Serving Sexual Assault Victims who are Minors. Jessica Mindlin of the Victim Rights Law Center will present successful approaches to identifying remedies and advocating for sexual assault victims who are minors.

Please anticipate information providing teleconference instructions and materials the day prior to the teleconference.

For reporting purposes, please let us know if additional staff from your organization plan on participating using the same phone line.

We thank you again for your interest in this teleconference and in the VRLC!

Thank you for your interest in this teleconference! This institute is entitled Serving Sexual Assault Victims who are Minors. Jessica Mindlin of the Victim Rights Law Center will present successful approaches to identifying remedies and advocating for sexual assault victims who are minors. Please anticipate information providing teleconference instructions and materials the day prior to the teleconference. For reporting purposes, please let us know if additional staff from your organization plan on participating using the same phone line. We thank you again for your interest in this teleconference and in the VRLC!   Full Name:
Organization:
Address:
City/Town:
State:	-- select state --AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming
ZIP/Postal Code:
Country:
Email Address:
Phone Number and Extension:

2. Please include all the emails of additional staff that may participate in the teleconference, but who will not need an additional line. Materials, evaluation tools, will be provided via email.

Separate individual emails by semi-colons.

Please include all the emails of additional staff that may participate in the teleconference, but who will not need an additional line. Materials, evaluation tools, will be provided via email. Separate individual emails by semi-colons.

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3. Please indicate all OVW grants to which you are a grantee or sub-grantee.

Please indicate all OVW grants to which you are a grantee or sub-grantee.   Grants to Indian Tribal Government Programs Education, Training and Enhanced Services to End Violence and Abuse of Women Education, Training and Enhanced Services to End Violence and Abuse of Women Later in Life Grants to Encourage Arrest Policies and Enforcement of Protection Orders Rural Domestic Violence, Dating Violence, Sexual Assault Stalking and Child Abuse Safe Havens: Supervised Visitation and Safe Exchange Grant Program STOP Violence Against Women Formula Grants Transitional Housing Assistance Grants Program Grants to Reduce Violent Crimes Against Women on Campus Grants to State Sexual Assault and Domestic Violence Coalition Programs Grants to Tribal Domestic Violence and Sexual Assault Coalitions Legal Assistance to Victims Grant Program Technical Assistance Provider Other

Other (please specify)

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4. Select what best describes your organization:

	Affiliation:	My Role is:
This question requires an answer.	Legal ServicesTransitional Housing/Shelter OrganizationEducation ServicesCourt PersonnelCultural Institutions/ServicesState Agency Select what best describes your organization:   This question requires an answer.   Affiliation:	Attorney, client servicesAttorney, policy and legislationPara-professional staffExecutive DirectorDirector of Legal ServicesOrganization ManagementVictim AdvocateProsecutor My Role is:

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5. Within my organization, my title is:

Within my organization, my title is: