Note: *FIELDS ARE REQUIRED

*Name:
*Title (parent, teacher, etc):
School/Organization:
Child(ren) age group supported:	Preschool Elementary Middle School High School
*E-Mail:
*Address Line 1:
Address Line 2:
*City:
*State:
*Zip:
*Phone:

FEAT/RI Member: You are a FEAT/RI member ONLY if your membership dues has been paid within the last year (12 months).
**IMPORTANT**
FEAT/RI expects registration to go beyond capacity and interested parents and professionals will be added to our cancellation waiting list. We respectfully request that if you are a parent of a child with autism registering to attend our event for free, please make every effort to attend, or contact us to cancel so we may allow those on our waiting list to attend. See Brochure for Cancellation policy. Thank you!