FREE Regional Workshop in Broward County!

FREE Regional Workshop in Broward County!

The Florida Department of Education, UM-NSU CARD &

the School Board of Broward County present the

9th Annual Issues in Autism Conference

April 14, 2007

8:30 am - 4:30 pm

Nova Southeastern University Health Profession’s Division

Room 2105 Steele Auditorium

3301 College Avenue

Fort Lauderdale, FL 33314

For more information contact: Lela Perkins at UM-NSU CARD (954) 262-7111 or

------

Be sure to contact your ESE District Staff or Staff Development Contact to determine the process for receiving in-service.

Registration Information

REGISTRATION IS MANDATORY……DEADLINE: April 6, 2007

Complete the attached registration form and submit to Lela Perkins at UM-NSU CARD

Email:

Mail: UM-NSU CARD, 3301 College Ave., Ft. Lauderdale, FL 33314

Fax: 954-262-2847

*All confirmations and/or reminders will be sent via email

Regional Training Registration Form

Please complete ALL sections of this form and submit. All confirmations and/or reminders will be sent via email.

Training Information

CARD Center Hosting Training

Florida Atlantic University (FAU) CARD

Florida State University (FSU) CARD

University of Central Florida (UCF) CARD

University of Florida- Gainesville (UF GV) CARD

University of Florida- Jacksonville (UF JAX) CARD

University of Miami-Nova Southeastern University (UM-NSU) CARD

University of South Florida (USF) CARD

Training Title / 9th Annual Issues in Autism Conference
Highlighting Our Schools: Best Practices for Classrooms
Training Date / April 14, 2007

Registrant Information

No Acronyms Please

Name / Work Phone / ()-
School Name
or Employer / FAX / ()-
City / Home Phone / ()-
County / Email
Are you Out-of-Field? Yes No
*Out-of-Field refers to a teacher in a district school system assigned to teach outside the area in which he or she was certified

------

Please use the legend below to complete the following information:

Job Title
School Type: / Class Type: / Certification:
Legend
Job title:
1.  Elementary Teacher (K-5)
2.  Middle School Teacher (6-8)
3.  High School Teacher (9-12)
4.  Multi-level Teacher (EL, MS, HS)
5.  Itinerant Teacher (K-12)
6.  PreKindergarten Teacher
7.  Student PK-12 / 8.  Family Member
9.  Paraprofessional
10.  Therapist (OT/ PT/ SLP)
11.  ESOL Teacher
12.  Title 1 Teacher
13.  District Program Staff
14.  Principal/ Assistant Principal / 15. Other School Professionals
16. Behavior Specialist
17. Social Worker
18. Psychologist
19. Counselor
20. Nurse
21. FDLRS Staff / 22. Project Staff
23. Other Agency Staff
24. Undergraduate Student
25. Graduate Student
26. In State Col./ Univ. Staff
27. Out of State Col./ Univ. Staff
28. Other School Support / 29. Bus Driver/ Aide
30. Substitute
31. Private Consultant
32. DOE Staff
33. Preservice Teacher
sCHOOL tYPE: / Class Type: / Certification:
AA.  Private
AB.  Charter
AC. Public
AD. N/A / BA.  General Education
BB.  ESE, NOT Autism
BC.  Autism
BD.  N/A / CA. General Education
CB. Varying Exceptionalities
CC. Other ESE
CD. Not Certified
CE. N/A