REGISTRATION FORM - "Federal Barriers to Community Living for People with Disabilities"

"Federal Barriers to Community Living for People with Disabilities: Recommendations for Change"
National Listening Session

September 5, 2001
Ronald Reagan Building & International Trade Center
Washington, DC

REGISTRATION FORM

Required fields are indicated with asterisks (*). Please check to make sure that your e-mail address is entered correctly. When the form is complete, click on the Submit button at the bottom of the page. If you do not have any information to enter into a required field, just type "NA".

The deadline to register for the meeting is August 31. The deadline to request an opportunity to provide oral testimony is August 22.

Register to Attend the Event

Registration Category*
	If other, please describe:
First Name*
Middle Initial
Last Name*
Department
Division
Organization
Address*

City*
State*
Zip Code*
If any meeting materials are mailed out prior to the meeting, do you want them sent to a different address?
	If yes, please type the full address here:
Telephone*
Fax*
E-Mail*
This facility is in compliance with the ADA, however, if you need any special accommodations, please describe below: (e.g., physical accommodation, materials in alternative format, sign language interpreter, etc.)

Request an Opportunity to Share Your Insights
WE WANT TO HEAR FROM YOU! Essential to the review of the federal programs is the involvement of consumers, advocacy organizations, providers, and relevant agency representatives. To that end, we are asking for you to share your insights. Please answer the following questions regarding your input for the meeting:
Would you like to request an opportunity to provide a 3-minute oral testimony?	(Deadline 08/16/01 - see "overview" page for more details)
What is your main issue of concern?
	If other, please describe:
What is your main topic of input (select all that apply)? * To select multiple topics, hold down the "Ctrl" key and click the appropriate selections.
	If other, please describe:

This page was last updated on Tuesday, August 14, 2001