Registration for NCD "Sharing Great Ideas" Meeting in Berkeley, CA

The National Council on Disability is pleased to be convening Sharing Great Ideas: Let's put our heads together and pioneer the next wave of disability policy" in conjunction with its May Quarterly meeting May 4-6, 2014 at the Ed Roberts Campus, 3075 Adeline, Berkeley, CA 94703.

Please assist us by completing this registration form and sharing it with other partners, colleagues and friends who may be interested in attending.

Please complete and reply by Friday, April 18. Thank you!

* 1. Contact Information

Full Name:

Organization:

Email Address:

Phone Number:

* 2. I plan to attend the NCD May Quarterly meeting (check all the apply)

Sunday, May 4 reception and networking

Sunday, May 4 Ignite Ability! presentations

Monday, May 5 Concurrent sessions

Tuesday, May 6 Morning concurrent sessions

Tuesday, May 6 Afternoon NCD Council Business meeting

For more information on items of the agenda referenced below, click here.

* 3. (Optional) I would like to lead a discussion during one of the concurrent sessions on the following topic (if so, the Meeting Planning Committee will follow up with you):

* 4. (Optional) I would like to make an Ignite Ability! presentation on the following topic (if so, the Meeting Planning Committee will follow up with you):

* 5. (Optional) I would like to have a table at the Marketplace of Ideas (if so, the Meeting Planning Committee will follow up with you):

* 6. I will be attending with (names of companions, caregivers, or other colleagues):

* 7. Please indicate what accommodations you may need.

American Sign Language (ASL) interpreter

CART services

Braille Materials

Large Print Materials

Assistive Listening Device

Materials in Electronic Format

None of the above

Other (please specify)

Thank you!

This concludes the online registration process.

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