TO REGISTER:

 

Interventionsfor Children with NLD and Other Social Learning Differences 

HUHA21-01 

WorkshopFee: $150

 Name________________________________

Address______________________________

City_________________________________

State/Zip_____________________________

Phone________________________________

Social Security#___________________________________________________

Profession ______________________ License Number___________________

Date of Birth_____________

Sex__

 

Credit CardInformation______________________________________exp.____

 

10% discount offered to two or moreparticipants from the same organization 

REGISTERBY FAX OR BY MAIL

 

ByFax: Complete registration form, include credit card number and expirationdate

Fax to:  (847) 635-1448 

ByMail:

Checks should be made payable to:OCC

Send checks and registration formsto: Alliance For Lifelong Learning, P.O. Box# 367, Skokie, IL 60076

 No confirmation of enrollmentwill be sent 

For additional information regardingregistration, call 847-635-1808

For additional information on workshopcontent, call 847-933-9339 x222