ADA Distance Learning 2000
Registration Form

This registration form can only be used for sites located in Illinois, Indiana, Michigan,
Minnesota, Ohio and Wisconsin.  This form can also be used for sites located
outside of Regions 3, 5, 6, 7 and 9 (see table for regions).

Site/Organization:
Site Coordinator Information
Name:
Address:
City: State: Zip:
Phone:
Fax:
E-mail:
Sessions:  
 
Definition of Disability
Common Errors & Omissions
ADA Implications for Managed Care
Interplay between ADA & FMLA
Effective Communication
Proposed Changes to ADAAG
Worker's Compensation & the ADA
Principles of Universal Design
Post-Secondary Education: ADA & Section 504
Celebrating the 10th Anniversary of the ADA
ADA in Unionized Environments
Accessibility & Technology
 
 
Method of Payment: To register via Purchase Order, Check, Visa/Mastercard, print this form
and return it by fax to (312) 413-1856 including the following:

Purchase Order # _______________________________________

Visa/Mastercard#_________________________________ Exp date ____________


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