FLORIDA DEPARTMENT OF EDUCATION

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BUREAU OF EXCEPTIONAL EDUCATION AND STUDENT SERVICES

District Autism Contact Persons’ Meeting

January 14, 2005

Response Form

Please fax this form to Sheryl Brainard at (850) 245-0955 no later than

January 7, 2005.

District:

Name:

Title/Position:

Phone:

E-mail:

I will be attending the District Autism Contact Persons’ Meeting on

January 14, 2005, in Orlando.*

I will not be attending the District Autism Contact Persons’ Meeting on

January 14, 2005, in Orlando.

*Individuals attending this meeting must also complete the registration form for the CARD