Florida Department of Education Center for Autism and Related Disabilities

FREE Regional Workshop inHighlandsCounty!

Thursday, February 16, 2006

School Board of HighlandsCounty Registration: 8:00 - 8:30

Physical Complex, Basic Programs Training RoomWorkshop: 8:30 - 3:00

426 School Street, Sebring, FL33870

Directions to Training Location:

Driving North on Hwy 27 to Sebring. Turn right at HighlandsRegionalHospital onto Highlands Ave.Go approximately2.5 miles to E.O. Douglas Ave. After you cross the second RR tracks start looking for E.O. Douglas Ave.Turn right on E.O. Douglas, go approximately1 mile.Turn left onto School St. the School Board of Highlands County is immediately on your right.Enter front office to ask directions to the Basic Program Training Room.School Board phone # 863 471 5555

Driving South on Hwy 27 to Sebring. Turn left at HighlandsRegionalHospital onto Highlands Ave.Go approximately 2.5 miles. After you cross the second RR tracks start looking for E.O. Douglas Ave.Turn right on E.O. Douglas, go approximately 1mile.Turn left onto School St. the School Board of Highlands County is immediately on your right.Enter the front office to ask directions to the Basic Program Training Room.School Board phone # 863 471 5555

For more information contact: Tanisha Clarke-Dobney at USF CARD 813-974-6168 ~ 800-333-4530 ~

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Registration Information

REGISTRATION IS MANDATORY

Complete the attached registration form and submit to Tanisha Clarke-Dobney at USF CARD

Email:

FAX: 813-974-6115

Mail: USF CARD▪ 13301 Bruce B. Downs Blvd. MHC 2113A ▪ Tampa, FL 33612

*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

CARDCenter 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 (UM) CARD

University of South Florida (USF) CARD

Training Title / Helping Students with Autism Spectrum Disorders Communicate
Training Date / February 16, 2006

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

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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
/
  1. Family Member
  2. Paraprofessional
  3. Therapist (OT/ PT/ SLP)
  4. ESOL Teacher
  5. Title 1 Teacher
  6. District Program Staff
  7. Principal/ Assistant Principal
/
  1. Other School Professionals
  2. Behavior Specialist
  3. Social Worker
  4. Psychologist
  5. Counselor
  6. Nurse
  7. FDLRS Staff
/
  1. Project Staff
  2. Other Agency Staff
  3. Undergraduate Student
  4. Graduate Student
  5. In StateCol./ Univ. Staff
  6. Out of StateCol./ Univ. Staff
  7. Other School Support
/
  1. Bus Driver/ Aide
  2. Substitute
  3. Private Consultant
  4. DOE Staff
  5. 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