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Oklahoma Parents Center - 17th Annual Statewide Conference Registration
"Building Relationships...Creating Successful Change!
"
Hosted by:
Oklahoma Parents Center, Inc.
in conjunction with
Oklahoma State Department of Education
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1.
What is your first name?
(Required.)
*
2.
What is your last name?
(Required.)
*
3.
Please list your gender.
(Required.)
Male
Female
Prefer not to disclose
*
4.
Please list your ethnicity.
(Required.)
Caucasian/White
Hispanic or Latino
African-American/Black
American Indian/Native American/Alaskan Native
Asian
Native Hawaiian/Pacific Islander
Two or more races
Prefer not to disclose my ethnicity
*
5.
What is your phone number?
(Required.)
6.
What is an alternative phone number?
7.
What is your mailing address?
*
8.
What is your email address?
(Required.)
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9.
Please list any special accommodations that you may require to attend the training, if any.
Translators, sign interpreters, and/or other special accommodations will be available upon advance request. Any requests made after
May 18th
, may not be available.
(Required.)
*
10.
How are you registering?
If you can fit into both Parent/Family
and
Professional, please select Parent/Family Member.
If you can fit into both Parent/Family
and
Self-Advocate/Student, please select Parent/Family Member.
If you can fit into both Self-Advocate/Student
and
Professional, please select Self-Advocate/Student.
(Required.)
Parent/Family Member
Self-Advocate/Student
Professional
