Registration for the NCDAE ATIA Meeting

Use the following form to register for the Accessible Distance Education National Discussion to be held in Orlando, Florida on Wednesday, January 18, 2006 from 12-4pm in conjuction with the Assistive Technology Industry Association conference.

NOTE: This form does not register you for the ATIA conference. Registration for the conference may be completed through the conference web site linked above. The following form registers you for the NCDAE discussion meeting to be held in conjunction with the conference.

First Name:

Last Name:

Your Email Address:

Your Project, Organization, or Institution Name:

Your Organization Web Site Address (include http:// at the beginning):

I would like to register for and am planning on attending the ATIA discussion meeting to be held Wednesday, January 18, 2006:
Yes
No

Please specify any accessibility accommodations:

Comments or suggestions: