* 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:
Session Name
Location
Date
No Refunds After Date
Fee Includes Lunch:
Registration Fee
Autism 101(6:00pm-8:00pm)
SCAS-HQ West Columbia, SC
Wednesday, 10/27/10
Not Applicable Cancellation notification is appreciated.
No
$0
* Cancellation fee (if cancelled before refunds date above) $10/session
*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).
