VOC 2024 Regional Events Registration

Register Now for Visions of Community Regional Event:

Western MA Edition

Registration Form: VOC 2024 Regional Events

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. Please contact us with any accommodation requests at info@fcsn.org.

Which regional event do you plan to attend?(Required)

Western, MA: UMass Amherst - April 27

First Name(Required)

Last Name(Required)

Email(Required)

Address

State

City(Required)

Out of State City

Zip/Postal Code(Required)

Organization

Gender Identify

Preferred Phone Number

Age of child with special needs?(Required)

Cell Phone

Home Phone

Work Phone

Primary Language(Required)

Other Language

Chinese Dialect

I am attending this event as a:(Required)

Are you a Special Education Surrogate Parent (SESP)?(Required)

What is your race?(Required)

What is your ethnicity?(Required)

What is your child's race?(Required)

What is your child's ethnicity?(Required)

What is your child's primary disability?(Required)

What is your child's secondary disability?

What is your total household income?

What is the highest level of education completed?

How many family members are in your household?

Specify race

How many people will be joining you?

Hidden

Specify child's race

Register Now for Visions of Community Regional Event:

Western MA Edition

Registration Form: VOC 2024 Regional Events

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