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A.T. Learning Center
7050 Oakland Mills Rd.
Suite 160
Columbia, MD 21046
410-381-COOP (2667)
410-381-2444 FAX

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410-290-1327
410-290-1012 FAX

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Last Updated 03.09.10

Workshop Registration

Last Name:
First Name:
Email Address:
School System or Organization Name:
Professional position OR "Family Member" (of someone with a disability):
Preferred address:
City, State, Zip:
If professional, in what county do you work? If parent, in what county do you live?:
Best daytime phone (work or cell):
Home Phone (in case of inclement weather):
Workshop selection(s): Pricing shown is Sustaining Member/Non-Member ADG0401 Adapting Board/Card Games ($67/$79)
TTT0414 Technology in Tough Times ($67/$79)
MNT0420 Make 'n Take ($67/$79 PLUS $30 materials fee for all)
LMN0428 Writing Letters of Medical Necessity $84/$99)
ACC0506 Access to Communication ($67/$79)
HGD0526 Handwriting: Let's Go Digital ($67/$79)
Special accommodations needed (Must receive notice 10 days prior to event):
I will be sending: a check
a purchase order
or using PayPal
My interest in this topic is as: an individual with disabilities
a family member of a person with disabilities
a service provider or educator
an employer
How did you hear about this event?:
I have read and agree to the Cancellation Policy as stated in the Training Section of the AT:LAST, Inc. website.
When you click "Submit" your reservation form will return to our website. Before you go, are there any other training topics you'd like us to sponsor?

 

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