VIISA Conference Registration

Course 1 - 2023-2024

Session 1: November 1-3, 2023

Session 2: April 10-12, 2024

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* 1. Full Name:

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* 2. Phone:

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* 3. Mailing address (street, city, state, zip):

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* 4. Email address:

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* 5. Would you like to be added to the MSB Outreach Professional Development email list? (we promise not to spam you!)

Yes

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* 6. Current Job Position:

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* 7. Agency/Program/School District:

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* 8. Are you currently serving a child with low vision/blindness?

Yes

If known, please list any eye conditions of children you serve:

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* 9. Will you be able to attend both the November 1-3, 2023 session and the April 10-12, 2024 session?

Yes

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* 10. Please list any needed accommodations (i.e. language interpretation, reading medium, dietary restrictions). Please note, any requests made after October 4 cannot be guaranteed, although we will make every effort to meet them:

Conference is provided free of charge. Working lunch will be provided on Thursday and Friday of each session. Transportation, lodging, and other meals will be the responsibility of the applicant.