CWDO Webinar Registration Form

Webinar Title

Date

First Name

Last Name

Email address

Telephone

TTY

Your question for the presenter

Which accommodations will you need during this webinar to ensure you can fully participate? *

I do not need any accommodations

I require real-time captioning

I require ASL interpretation

I require Intervenor assistance

I require Note taking assistance

Other (Specify)

We will do our best to arrange for the accommodation needed, given the amount of notice we have from you and funds available.

Thank you!

* = Input is required