Mailing List Online Registration Form

Name:
Position/Title:
School:
District:
Work Address:
City:
Work Phone:
Home Phone:
Cell Phone:
E-mail:
Fax:
Please send me workshop information for:
Administrators
 Agencies
 CAC Parents
 CASEMIS/SIS
 Clinics
 Colleges
 High Schools
 IEP Coaches
 Mental Health Group
 Migrant
 Miscellaneous
 Parents
 Preschool
 Principals – Bakersfield City
 Principals – Kern County
 Psychologist
 Regional Groups
 Special Ed. Contact – SEAC
 Special Ed. Teachers
 Specialists
 Speech Pathologist
 Superintendents
 Surrogate Parents
 Testing

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