Department of Education

Chantal Vachon
CSPD Project, University of South Florida
1. St. Petersburg, FL 33701-5016

Please type or

Department of Education

OT/PT Weekends with the Experts

December 6-7, 2002

Altamonte Springs, Florida

Name of School District: __________________________________________________________________

Address:_______________________________________________________________________________

Name of District OT/PT Coordinator: ________________________________________________________

Phone Number:______________________ Email: _________________________________________

Do not register

more than the following number of participants per district for the workshop on December 6-7,

2002, in Altamonte Springs, Florida.

Number of participants:

8 per very-large size district

(Dade, Broward, Hillsborough, Palm Beach, Orange, Duval, Pinellas)

6 per large size district

(Polk, Brevard, Volusia, Seminole, Lee, Pasco, Escambia)

4 per medium size district

(Marion, Manatee, Sarasota, Leon, Collier, Okaloosa, Osceola, Alachua, St.

Lucie, Lake, Clay, Bay, Santa Rosa, St. Johns)

2 per med-small size district

(Charlotte, Hernando, Martin, Citrus, Indian River, Putnam, Highlands, Nassau,

Monroe, Columbia, Gadsden, Jackson, Hendry)

1 per small size district

(Okeechobee, Levy, Flagler, Sumter, Walton, Suwannee, Hardee, Baker,

DeSoto, Wakulla, Bradford, Taylor, Holmes, Madison, Washington, Gilchrist,

Dixie, Union, Gulf, Calhoun, Hamilton, Jefferson, Franklin, Liberty, Glades,

Participant's Name

Position in District

(Indicate if participant is an

___ The district OT/PT Coordinator will attend a meeting on December 5, 2002, from 10:00 a.m. – 3:00 p.m.

___ The district OT/PT Coordinator will attend the December 6-7, 2002, Weekends with the Experts.

_________________________________________________________

If there is space available, I have additional therapists who would like to attend this workshop (please list on an

additional sheet of paper).

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Please mail or fax

no later than 11/18/02

to:

Chantal Vachon

CSPD Project, University of South Florida

Avenue South, SVB 108

St. Petersburg, FL 33701-5016

FAX 727- 553-3180 Telephone 727-553-3187