Together we can solve the puzzle

South Carolina Autism Society

Workshop Registration Form

* All Fields Required.
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* Your Name
* Your Address 1
Your Address 2
* Your City    * State       * Zip Code   
* Phone Please include area code.
* Your E-mail (Changes will be sent by email.)

YES

NO

* Please indicate
which category
best describes you:
Parent Medical Professional
Service Provider Family Member    
Educator Individual with Autism
Other: 

Select Sessions You Wish to Attend:

Select Workshop

Session Name

Location

Date

No Refunds
After Date

Fee Includes
Lunch:

Registration
Fee

OH! That Makes Sense! Understanding the Sensory World of Autism(10:00am-12:00noon)

SCAS HQ
West Columbia

Saturday, 12/6/08

11/20

no

$20

SO BIG Interventions (Successful Outcomes through Behavioral, Instructional and Generalization Interventions)(9:30am-12:30pm)

SCAS HQ
West Columbia

Thursdays, 01/08, 01/15, 01/22, and 01/29, 2009

12/22/09

no

$25

Autism 101(6:00pm-8:00pm)

SCAS-HQ
West Columbia, SC

Wednesday, 01/14/09

No

$0

Navigating the Social World(9:00am-4:00pm)

Columbia Conference Center
169 Laurelhurst Ave.
Columbia, SC

Friday, 02/20/09

2/06**

Yes

$75

Autism 101(6:00pm-8:00pm)

SCAS-HQ
West Columbia, SC

Wednesday, 04/22/09

No

$0

* Cancellation fee ( if cancelled before refunds date above) $10/session
** Cancellation fee ( if cancelled before refunds date above) $20/session

NOTE: Registration for Creating Visual Supports for Children with Autism Skill-building sessions on Tuesdays 2/10-3/17/2009 will be handled at SCATP Training Registration

   *Payment Type:

Check (mailed) Check #:

Money Order (mailed) MO #:

Purchase Order (mailed) PO #:

Payment by Credit Card

A limited number of Scholarships for PARENTS are available at no cost for some workshops. Early requests are strongly recommended. Scholarship requests also can be faxed (print this form including pertinent information and fax it to 803-750-8121).