C2P2 EI - Application

APPLICATION—Please complete the form below

Session Dates:
2013 - November 1-2.
2014 - January 10-11, March 7-8, May 2-3.

Location: Heritage Hotel, 500 Centerville Road, Lancaster, PA 17601. Tel: 800-223-8963.

Questions? Contact Cathy Roccia-Meier, Institute on Disabilities: 215-204-1772, cathyRM@temple.edu.

To register: Please complete the form below.

Items marked with * are required.

If you are a parent of a child/children with a disability/disabilities, please provide the following:

Are you currently employed in developmental disabilities or a related field?

Will you make a time commitment to travel and attend training in Lancaster, PA? (Friday and Saturday for 4 sessions, beginning November 2013)

List two references:

About C2P2 EI