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Conference for Families with Deaf or Hard of Hearing Children Registration Form
Please feel free to contact Jennifer Clark with any questions or concerns regarding this conference: Jennifer.Clark.dhh@gmail.com or call 808-679-1370
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Name
Your answer
Email
Your answer
Phone
Your answer
Name of Deaf/Hard of Hearing Child
Your answer
Age of Deaf/Hard of Hearing Child
Your answer
How many adults will be attending?
Your answer
To request childcare, please write names and ages of all children.
Your answer
To apply for the neighbor island travel scholarship, please check the box below.
I'd like to apply for the travel scholarship.
Accommodation Request
ASL Interpreter
Communication Access in Real Time (CART services)
Large print
Braille
Other:
Questions
Your answer
How did you hear about the conference?
Facebook
Instagram
Email Invitation
Phone or Text Invitation
Word of Mouth
Other:
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