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  Date of request: Phone:  
  School/Agency: Fax:  
  Contact Person: Position:  
  Adminstrator:    
  Address01:      
  Address02:    
  Address03:    
  City: State:  
  Zip Code +4  E-mail:  
               
We are requesting training in the following area(s):
 
 
 1. Early Childhood:
 
 
   Tips on Toileting
 
   Helping Children Communicate
 
   Strategies to Promote Positive Behavior Changes
 
  Getting What You Need for Your Child
 
  How to Teach New Skills
 
  Support Strategies for a Child's Transition to a New Classroom
 
 
2. School Age:
 
 
   Promoting Social Skills
 
   Teaching Independence in Daily Living Skills
 
   Creating Visual and Enviornmental Supports
 
   Collaboration and Person-Centered Planning
 
   Enhancing Communication Skills
 
 
3. Adolescent to Adult Issues :
 
 
   Successful Transition to Adult Life
 
   An Introduction to the Adult Services System
 
   A Guide to Self-Determination
 
   Supported Employment
 
   Community Living
 
   Guardianship and Estate Planning
 
 
4. Miscellaneous:
 
 
   Overview of Autism
 
   Overview of Asperger's Syndrome
 
   Data Collection
 
   Teaming and Collaboration
 
   Other (Please Explain):
  
 
 
5. Special Projects:
 
 
   New Teacher's Training Series
 
   Building an Environment for Success for Students with Asperger's Syndrome.
 
   Developing Effective Skills for Para-Professionals Working with Students with Autism and Related Disabilities.
 
   Consultation to Help Assess Training Needs and Develop Follow Up Trainings for Professional Development.
 
 
6. What do you hope to achieve from this training? Describe the desired outcomes.
 
 
  
 
 
 
7. List preferred dates, days of the week, times, location, number of participants, and make-up of audience.
 
 
  
 
 
8. Other relevent information:
 
    
 
               
           
               
         
 
   
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© Center for Autism and Related Disabilities
Louis de la Parte Florida Mental Health Institute, University of South Florida
13301 Bruce B. Downs Blvd., Tampa, FL 33612-3807
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