Registration Form

National Indian Parent Information Center

560 A NE “F” Street, PMB 418

Grants Pass, Oregon 97526

1-877-205-7501 (toll free)

(541) 472-9467

Email: Indian.info@nipic.org

Website: www.nipic.org

Contact Person: ____________________________________________________________________

Organization: ______________________________________________________________________

Tribe: ____________________________________________________________________________

Address: _____________________________________________ City: ________________________

State: ________________________________________________Zip: _________________________

Phone: _________________________________________Cell:_______________________________

Email: ____________________________________________________________________________

I wish to request the following workshop(s):

COMMUNITY FRIENDS TRAINING

This workshop is 6-8 hours

It is an overview of the Special Education Rights (Overview of the Individuals with Disabilities Education Act). And the Parent leadership training Section 504

Individualized Education Program (IEP)

Individual Family Service Plan (IFSP)

Transition – a workshop to assist planning for their children for what happens after High School

Section 504 – what happens if children no longer qualify for an IEP?

Working with Professional

All National Indian Parent Information Center trainings are 2 – 6 hours long.

I am interested in tailoring a training to meet the needs of my community and am willing to contract with NIPIC to conduct this training. You will need to work with main office to contract and schedule this training.

Please fax the request for a workshop form to (541) 472-9611

or mail to: NIPIC

560-A NE “F” Street, PMB 418

Grants Pass, Oregon 97526