Addressing Puberty & Sexuality Concerns With Students Who Have Multiple Disabilities      

Registration Form

To register for the Puberty & Sexuality Concerns training, please complete the boxes below and click Submit. 

1.    First Name: 

2.    Last Name: 

3.    Mailing Address (summer)

4.    Email Address (summer)

5.    Phone (summer)

6.    Accommodations (check all that apply):  (Accommodation requests must be received by July 27, 2009)

Large Print

Braille

ASL Interpreter

Special dietary concerns (Please specify)

Other (Please specify)

7.    In what region do you currently live?

Region 1 (Emmet, Cheboygan, Presque Isle, Charlevoix, Antrim, Otsego, Montmorency, Alpena, Leelanau, Benzie, Grand Traverse, Kalkaska, Crawford, Oscoda, Alcona, Manistee, Wexford, Missaukee, Roscommon, Ogemaw, Iosco, Clare, Gladwin, Mason, and Lake)

Region 2 (Osceola, Arenac, Mecosta, Isabella, Midland, Bay, Gratiot, Clinton, Eaton, Ingham, Livingston, Shiawassee, Genesee, Lapeer, Sanilac, Huron, Tuscola, Saginaw)

Region 3 (Oceana, Newaygo, Montcalm, Muskegon, Ottawa, Kent, Ionia, Allegan, Berry, Berrien, Van Buren, Cass, Kalamazoo, Calhoun, St. Joseph, Branch, and Hillsdale)

Region 4 (Monroe, Lenawee, Jackson, Washtenaw, Wayne, Oakland, St. Clair, and Macomb)

Region 5 (The Upper Peninsula)