Hand in Hand Training Registration

Fall 2022

Session 1: October 26-28, 2022

Session 2: November 16-18, 2022

Registration deadline: September 23, 2022.

Question Title

* 1. Name (First & Last):

Question Title

* 2. Email address:

Question Title

* 3. Mailing address (street, city, STATE AND ZIP)So we can mail your training package:

Question Title

* 4. Phone:

Question Title

* 5. Agency/Program/School District:

Question Title

* 6. Your role, position, or job title:

Question Title

* 7. Are you currently serving a learner with duel sensory (hearing and visual) impairments?

Yes

If yes, please provide brief description of what you know about that child's vision and hearing etiology/status.

Question Title

* 8. Are you a caregiver for a child with both visual and hearing impairments?

Yes

If yes, please describe the nature of the child's hearing and visual abilities.

Question Title

* 9. Do you have any known conflicts with any of the training dates?

Yes

If yes, please elaborate:

Question Title

* 10. What is one thing you hope to learn from participating in Hand in Hand?

Question Title

* 11. Are you interested in receiving CEUs or College Credit for this training?

College Credit

AER/ACVREP

Other (please specify)

None of the above

Question Title

* 12. Lunch will be provided for all full-day sessions. Do you have any food allergies or dietary needs?

Yes

If yes, please describe your dietary needs (i.e. peanut free, gluten free, etc.)

ADA Related Accommodations
If you would like to request accommodations under the Americans with Disabilities Act (ADA/ADAA) please email the training coordinator, Natasha Baebler, at natasha.baebler@msb.dese.mo.gov with the subject line "Hand in Hand ADA Request". In order for accommodations to be in place for the first day of training, requests should be received by the registration deadline. After this date, reasonable attempts will be made, but can not be guaranteed.