If you would like to receive email notices of the MD A.T. Co-op's workshops and special sales, please email training@matcoop.org with the SUBJECT: "Sign me up!"

REGISTRATION

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Last Name
First Name
Email Address:
School System or Organization Name
Position OR Family Member
Preferred address
Preferred Address City, State, Zip
If professional, in what county do you work? If parent, in what county do you live?
Work or Cell Phone
Home Phone (in case of inclement weather)
If no e-mail available,provide a number where you can receive a faxed confirmation.
Are any special accommodations needed? (Must receive notice 10 days prior to event)
I will be mailing	a personal check an institutional 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 an employer
Which days will you be attending?	Thur Jan 22 Wed Feb 18 Wed March 4
How did you hear about this event?	received e-mail notice received flyer about the event co-op website word of mouth recommendation on professional listserve other
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 this year?

CANCELLATION POLICY
Only pre-registration fees are refundable if the Co-op receives written notice of your cancellation at least 72hours (2 business days) in advance of the workshop. A $25 processing fee will be assessed for each cancellation. (In the case of make and take workshops the materials fee plus $25 will be assessed.) Substitutions are always welcome. No-shows are not considered cancellations and payment-in-full still applies. The Co-op reserves the right to cancel any workshop in which case a full refund will be issued.

Mailing Address for Payment
P.O. Box 428
Savage, MD 20763

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