Workshop Registration Form

This workshop is open to parents & guardians of WV children who are Deaf or hard of hearing.

Join other families as we discuss topics such as:
Advocating for your child
Language & Communication
Navigating Early Intervention
Understanding Audiology

Activities for your children will be provided by the West Virginia School for the Deaf Outreach Program.

Workshop Dates / Locations

February 8, 2020 / Lewisburg / Quality Inn, 178 Coleman Drive, Lewisburg, WV 24901
March 14, 2020 / Martinsburg / Comfort Inn Aikens Center, 1872 Edwin Miller Blvd., Martinsburg, WV 25064

This program is being presented with financial assistance as a grant from the West Virginia
Department of Health and Human Resources.

Email address *
Please Note… This workshop is provided free of charge to families of WV children who are deaf or hard of hearing. *
Contact Person *
Your answer
Address *
Your answer
Phone Number *
Your answer
County of Residence *
Which workshop/location will you be attending? *
Will you be attending the workshop in person or be participating online using Zoom? *
How many people in your family will be attending?
Please answer for each age group below.
Adults *
Children (Birth to Three) *
Children (Ages 4 - 12) *
Teens (Ages 13 - 17) *
Are any of the children attending deaf or hard of hearing? If so, please list the name and age of each child.
Your answer
We want to ensure that your child is safe and happy. The WVSD Outreach team are highly skilled Teachers of the Deaf who are experienced with deaf and hard of hearing children. Please indicate here if your child/children have a condition or disability that require additional accommodations.
Your answer
A sign language interpreter will be provided for parents who are deaf or hard of hearing who will be attending the parents' session. Please indicate below if you need an interpreter. *
Is there a particular topic that you would find beneficial for your family? Feel free to list any topics or specific questions you would like to see covered. We will try to accommodate your request if possible.
Your answer
Subject to grant funding, mileage reimbursement may be available to parents of deaf or hard of hearing children who attend. Would you like to be considered for mileage reimbursement?
Food and drinks will be served. Please indicate any allergies of which we should be aware. We want to be make our event safe for everyone.
Your answer
A copy of your responses will be emailed to the address you provided.
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