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What age level students do you work with?
Choose one of the following to describe your position: Administrator, SE Administrator, GE Guidance Counselor Human Services Agency Staff Occupational Therapist Other related service provider Paraprofessional Parent/Family Physical Therapist Speech Pathologist Teacher, SE Teacher, GE Transition Coord. Univeristy Professor/Student Vocational Teacher/Administator Other
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Disability Descriptions (please check all that apply): ADD/ADHD Autism Deaf Blind Deafness Developmental Delays Severe Emotional Disturbance Hearning Impairment Learning Disability Mental Retardation Multiple Disabilities Orthopedic Impairment Speech/Language Impairment Traumatic Brain Injury Visual Impairment Other Health Impairment Severe Disability
Choose which of the following describe your program affiliation: Early Childhood Special Education Early Intervention General Education School Age Special Education Other Adult Education/Family Literacy Even Start Head Start Homeless Migrant Education Occupational Child Care Preschool Initiative Title 1
Training and Technical Assistance Center (T/TAC W&M) William and Mary School of Education P.O. Box 8795 Williamsburg, VA 23187-8795 Phone: (800) 323-4489 TDD: (757) 221-2302 FAX: (757) 253-4897
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