Law Enforcement, First Responder, or Disability Service/Educator/Advocate Registration for "Understanding Autism" Training and "BE SAFE" Movie Screenings
This is the registration form for "Understanding Autism and Other Intellectual and Developmental Disabilities," and "BE SAFE Interactive Movie Screenings." Sessions are from 12:00 pm to 4:00 pm for the state-mandated training with Pathfinders for Autism, and from 6:00 pm to 8:30 pm for the interactive sessions with teens and adults with ARC of Southern Maryland. You are encouraged to register for both sessions. All training is free and all materials are provided.
This Google Form may be used by any police officer or other law enforcement professional, any first responder (e.g. fire, medical, rescue diver, etc.), any professional working in these fields, or any disability service provider, special educator, or disability support advocate, and any professional working in those fields.
Individuals with disabilities, or family members/caregivers, registering for "BE SAFE" should register separately at the "BE SAFE MOVIE" webpage on the ASSG website, or they may call or email to register. Do NOT use this Google Form. For more details, visit our website at
Please indicate the date and location you wish to register for, which session(s) you wish to attend, and the individual who will be attending on that date. If you have more individuals who you are registering, or if you wish to register individuals for additional dates, simply submit a new form. You may also request a spreadsheet for data entry for multiple attendees from, or email the information to, June at
If you have any questions, please call ASSG at (240) 561-8860 or contact us by email.
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I would like to attend "Understanding Autism" as a law enforcement officer or first responder for the purposes of certified training on the date indicated:
Thursday June 8, 2017 at St. Mary's College of MD in St. Mary's City - 12:00 - 4:00 pm.
I am not attending "Understanding Autism" at this time, or I am not a law enforcement officer or first responder
I would like to attend "BE SAFE" as a law enforcement officer or first responder in order to be a training volunteer on the date indicated:
Wednesday May 17, 2017, at ARC of Southern Maryland in Prince Frederick - 6:00 - 8:30 pm
Thursday June 8, 2017, at St. Mary's College of MD in St. Mary's City - 6:00 - 8:30 pm
I am not attending "BE SAFE" at this time, or I am not a law enforcement officer or first responder
I would like to attend "Understanding Autism" or "BE SAFE" for information as a disability service provider, special educator, or support advocate
"BE SAFE" on May 17 from 6:00 - 8:30 pm in Prince Frederick
"Understanding Autism" on June 8 from 12:00 - 4:00 pm in St. Mary's City
"BE SAFE" on June 8 from 6:00 - 8:30 pm in St. Mary's City
I am a law enforcement officer or first responder
First Name of Registrant:
Last Name and Suffix (Jr, III, etc.)
Title, Rank or Position:
Company, Organization or Agency:
Phone Number and Extension:
County You Work In:
Comments, Questions, or Accommodations Desired:
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Autism Spectrum Support Group of Southern Maryland.
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