Fall 2009 Workshop - Registration

 

Part 1 - Registrant Information:

 

First Name
Last Name
Institution
Department
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country if not USA
Telephone
FAX
E-mail

 

Part 2 - Registration Information

 

AHEAD member on or before 9/11/2009: US$259
AHEAD member after 9/11/2009: US$299
Non-member on or before 9/11/2009: US$349
Non-member after 9/11/2009: US$399

 

The Workshop I will attend is (CHOOSE ONE ONLY):

 

Constructing A New Framework: Evolving the Service Delivery Paradigm
Disability Services in the Community College

 

Part 3 - Programmatic Access Information:

 

Please check here if you have any disability related access requirements for the workshop. A member of the AHEAD staff will contact you directly to make necessary arrangements.

 

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