6th Annual Summer Institute in Assistive Technology
June 4 -5, 2009
Registration for Summer A T Workshop
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Descriptions
Schedule Registration CEU Credit and
Contact Info
*Name  Title

Agency, Organization or Company 

Profession or Job Title

*Email Address

*Mailing Address (Street/PO Box)

*City *State   *Zip

*Phone( ) If OVR is payor, Please indicate here
*Please Select (Check) the Workshops You Wish to Attend:



Day One



Day Two





Payment

Full Conference = $80 ($70 if pre-paid by May 9, 2009)
Single Day = $50
One Half Day = $30
This event is free to all consumers
Contact Kathy Sheppard-Jones at 859-257-8104 for more information

Send either check or institutional purchase order to:
Kathy Sheppard-Jones
Human Development Institute
University of Kentucky
210 Mineral Industries Building
Lexington, KY 40506-0051

         Note: Make check out to "University of Kentucky" and be sure to include your name(s) with the payment

         Accommodations / RESNA or other CEUs

         Please describe the accommodations required or CEUs you are seeking 

         Lunch will be provided for those attending one or both full days of this event

* = Required Information
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