Name *

First Name

Last Name

Phone

(###)

###

####

Which of the following pertains to you? *

Select all that apply.

Individual with intellectual or developmental disabilities

Parent of individual with intellectual or developmental disabilities or autism.

Teacher (Pre-K)

Teacher (K-12)

Teacher (Higher education)

Teacher (Special Education)

Undergraduate student enrolled in a program for serving individuals with intellectual and developmental disabilities and/or autism.

Graduate student enrolled in a program for serving individuals with intellectual and developmental disabilities and/or autism.

Licensed or Board Certified Behavior Analyst

Licensed or Board Certified Assistant Behavior Analyst

Licensed Behavior Interventionist or Registered Behavior Technician

Select the dates you plan to attend

(Select one or many)

April 3

April 10

April 17

April 24

May 1

May 8

May 15

May 22

May 29

June 5

June 12

June 19

June 26