Functional Vision and Hearing Screening - March 7, 2019 - Rockford
Center for Sight & Hearing
8038 Macintosh Lane
Rockford, IL

8:30 - 9:00 am Registration
9:00 -11:30 am Morning presentation (Vision or Hearing)
11:30 -12:30 pm Lunch break
12:30 - 3:00 pm Afternoon presentation (Vision or Hearing)

Email address *
You will receive all notifications via email so please be sure it is accessible throughout the year in case we need to send something over Summer, Winter and Spring breaks.
Last Name *
Your answer
First Name *
Your answer
Phone Number *
Mobile number is preferred in case there is a last minute cancellation or change.
Your answer
Job title *
Your answer
Do you need Early Intervention (EI) Credit from the Department of Human Services Bureau of Early Intervention? *
Do you need Professional Development (PD) Credits from the Illinois State Board of Education (ISBE)? *
If you entered "Yes" above to needing PD credit, please enter your IEIN here.
***We cannot give you credit without this number.***
Your answer
Americans with Disabilities Act (ADA) Accommodations *
If an accommodation is requested, please describe. ***Request is due two (2) months before date of training.***
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