Assistance Request All fields are required. First Name Last Name Email School Name School District Title ---Administrator, General EducationAdministrator, Special EducationGuidance CounselorHuman Services Agency StaffOccupational TherapistParaprofessionalParent/FamilyPhysical TherapistSpeech-Language PathologistTeacher, General EducationTeacher, Special EducationTransition CoordinatorUniversity FacultyVocation Teacher/AdministratorOther Program Affiliation Choose all that apply. Adult Education/Family LiteracyEarly Childhood Special EducationEarly InterventionEven StartGeneral (or Regular) EducationHead StartHomelessMigrant EducationOccupational Child CarePreschool InitiativeSchool Age Special EducationTitle 1Other Disabilities Served Choose all that apply. AllADD/ADHDAutismBlindDeaf-BlindDeafDevelopmental DelayEmotional DisabilityHearing ImpairmentIntellectual DisabilityLearning DisabilityMultiple DisabilitiesOrthopedic ImpairmentOther Health ImpairmentSpeech/Language ImpairmentTraumatic Brain InjuryVision Impairment Describe Request:
