VIISA II Conference Registration 2024-2025 Survey

1.Full Name:(Required.)

2.Phone:(Required.)

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

4.Email address:(Required.)

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

Yes

6.Current Job Position:(Required.)

7.Agency/Program/School District:(Required.)

8.Are you currently serving a child with low vision/blindness?(Required.)

Yes

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

9.Will you be able to attend both the November session and the April session?(Required.)

Yes

10.Please list any needed ADA accommodations (i.e. language interpretation, reading medium, braille, etc ). Please note, any requests made after October 11 cannot be guaranteed, although we will make every effort to meet them:

11.We will be providing lunch to all each full day of the event.

We know we can't accommodate everyone's tastes and diets, so ask that if you have any strict allergies or restrictions that you plan to bring your own packed lunch. Refrigeration space and microwaves are available upon arrival.(Required.)

I understand!

Current Progress,

0 of 11 answered

VIISA II Conference Registration 2024-2025

VIISA Course 2: Working with Preschoolers with Vision Impairment/Blindness in Center-Based Settings