Thank you for your interest in attending one of the DD Council's 'Crucial Conversation' sessions. We're looking forward to hearing from you. 

Mileage and/or Childcare Reimbursement are available for those who qualify.

If you have any questions please call Judy at 517-284-7297.

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* 1. Which location are you attending?

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* 2. Please fill out the information below

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* 3. Are you:

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* 4. Will you be accompanied by a personal care attendant?

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* 5. Do you use a mobility device?

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* 6. Will you be accompanied by a service animal?

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* 7. Choose three (3) topics that are a priority to you (if there is a topic not listed that is a priority to you, please fill it in under other).

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* 8. Please list any accommodations you need to fully participate.

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* 9. Please list any dietary restrictions.

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* 10. Will you need mileage reimbursement?

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* 11. Will you need childcare reimbursement?

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