Workshop Registration Brochure

Register for a Workshop
Register for SCEIs Training
Register for Credential Workshop
Directions to SCEIS Workshops

	Workshop Information for 2002-2003 Workshops are scheduled January 2003 through September 2003.
		SCEIs workshops are limited to Babies Can’t Wait personnel, providers and parents.
		Pre-registration is REQUIRED. No one will be allowed to attend a workshop without pre-registering at least one week in advance.
		Workshop registrations will be taken on a first come, first served basis.
		Each workshop is limited to 20 participants.
		Written confirmation of registration and directions to the workshop site will be mailed or faxed to participants prior to each workshop.
		To receive a certificate of completion, workshop participants must be present from 8:30 am - 4:30 pm and complete an Individual Learning Project. Professional Development ends at 1:00 pm and does not require an Individual Learning Project.

Workshop Registration Form

Please fill in this form and it will be electronically transmitted to the SCEIs office. You will receive a mailed or faxed confirmation.

In order to register for a SCEIs workshop you MUST be able to answer YES to one
of these questions.
Please check the one that applies to you.

Are you or the agency that you work for under contract with Babies Can't Wait?

Are you the parent of an infant or toddler who is receiving services from Babies Can't Wait?

You may register for all of your workshops on your level:
(6 if you are a Level I personnel;5 if you are a Level II)

Evaluation & Assessment:
Family Systems:
Professional development:
Program Implementation:
Team Process:
Typical/Atypical Development:
Participant's Name:
Title/Job Responsibility:
Social Security Number:
Health District Served:
(Mailing Address)Number & Street:
City, State:
Zip Code:
Telephone:
Fax:
E-mail Address:

Discipline Area: (please select one)

Level I (no degree in an early intervention discipline)

Parent Child Care Practitioner EI Assistant

Level II (degree in an early intervention related discipline)

Service Coordinator E.I. Specialist Early Interventionist

Discipline area: (Level II only -please check one)

Psychology Nutrition Nursing Social Work Therapist (OT, PT, Speech, Audiology)
Education (Special Ed.) Education (Early Childhood)

I require special services and facilities (please list):

Credential Workshop Date:

Participant's Name:

Title/Job Responsibility:

Social Security Number:

Health District Served:

(Mailing Address) Number & Street:

City, State:

Zip Code:

Telephone:

Fax:

E-mail Address:

Level: (please select one)

SCEIs Level I
SCEIs Level II

I require special services and facilities (please list):

Please check:

I have "passed" the PRAXIS
I have Certificates of completion for the 6 SCEIs Modules
I will need hotel information

Lunch may be purchased at the workshop site or you may bring a lunch with you.