Special Education Due Process Hearings & State Complaints
Wednesday, November 28, 2018
10:00am-12:00pm
East Bank Regional Library
4747 W. Napoleon Ave.
Metairie, LA 70001
I am attending this training as a(n)
Parent/Guardian of a child with a disability
Educator
Professional - Non Educator
Youth with a disability - under 18
Adult with a disability - over 18
First Name
Last Name
School or Organization Name
Job Title
Preferred Phone
Please select...
Home
Mobile
Work
Work Phone
Mobile Phone
Can we text this number?
Yes - ok to text
No - do not text
Home Phone
Email
Address Type
Please select...
Home
Work
Mailing Street
Mailing City
Mailing State
Mailing Zip
Parish
Please select...
Acadia
Allen
Ascension
Assumption
Avoyelles
Beauregard
Bienville
Bossier
Caddo
Calcasieu
Caldwell
Cameron
Catahoula
Claiborne
Concordia
Desoto
East Baton Rouge
East Carroll
East Feliciana
Evangeline
Franklin
Grant
Iberia
Iberville
Jackson
Jeff Davis
Jefferson
Lafayette
Lafourche
Lasalle
Lincoln
Livingston
Madison
Morehouse
Natchitoches
Orleans
Ouachita
Out Of State
Plaquemines
Pointe Coupee
Rapides
Red River
Richland
Sabine
St. Bernard
St. Charles
St. Helena
St. James
St. John
St. Landry
St. Martin
St. Mary
St. Tammany
Tangipahoa
Tensas
Terrebonne
Union
Vermillion
Vernon
Washington
Webster
West Baton Rouge
West Carroll
West Feliciana
Winn
Demographic Information
What is the IEP primary exceptionality for the child/student with disability?
Autism
Deaf-Blindness
Hearing Impairment
Developmental Delay
Emotional Delay
Intellectual Disability
Multiple Disabilities
Orthopedic Impairment
Other Health Impairment
Specific Learning Disability
Speech or Language Impairment
Traumatic Brain Injury
Visual Impairment - Blindness
Inappropriately Identified
Suspected or not yet identified
Gifted/Talented
All Disabilities
504 Plan - check here if child has 504 plan
Birthdate of child with disability (XX/XX/XX)
If you have more than one child with a disability, please provide additional information here
As a grant requirement, we are expected to provide support and training to all individuals. Therefore our grant requires us to report on the following ethnicity question:
Do you consider yourself
African-American
Asian
Caucasian/White
Hispanic/Latino
Native American
Native Hawaiian/Pacific Islander
Other
I prefer not to answer
Special Accommodations: please list any special accommodations needed to fully participate in this event.
Email newsletter
Yes! Please add me to your email list
No thank you
Contact Record Type (hidden)
Contact Information