Family Engagement Panel

Family Engagement Panel Registration

The Federation for Children with Special Needs is funded by grants which require us to collect data. Our registration is confidential and used to ensure we are supporting all communities. We do not share personal information nor do we sell to third parties.

First Name(Required)

Last Name(Required)

Email(Required)

Address

City

State

Zip/Postal Code(Required)

Phone

Organization

Primary Language(Required)

Which gender identity do you identify as?

How old is your child with special needs?

Other Language

Are you attending this event as a (check all that apply):(Required)

Parent/Caregiver

Foster Parent

Grandparent

Student (14-22)

Professional Educator

Professional Other

Special Education Decision Maker (SESP)

Other

Out of State City

What is your ethnicity?

What is your child's ethnicity?

What is your race?

What is your child's race?

Specify race

Specify child's race

What is your child's primary disability?

What is your child's secondary disability?

What is your total household income?

What is the highest level of education that you have completed?

How many family members are in your household?

What question do you have for the presenter?

If you need any accommodations (including language) to access this webinar, please describe below. Thanks.

Family Engagement Panel Registration

Your Support Moves Dreams Forward

Your Support
Moves Dreams
Forward