Job Accommodation Network Web Training
Downloaded Registration Form

All registrants will receive training materials for each session, which
will be sent via e-mail three to five business days prior to the
scheduled event. These materials will be in an accessible format and may
include Microsoft Word and PowerPoint, as well as Adobe PDF files.

Any registered participant who does not have access to e-mail should
indicate this at the time of registration, and training materials will
be sent via postal mail. When requesting postal mail, please indicate if
alternate format (large print, computer file, Braille) is needed and
what format you prefer. One set of materials will be mailed per
registration.

Registration Coordinator
Job Accommodation Network
West Virginia University
P.O. Box 6080
Morgantown, WV   26506-6080
800-526-7234 Voice
877-781-9403 TTY
304-293-5407 FAX
E-Mail: training@jan.wvu.edu

Ways to register:
1. Online. Please fill out the form at http://www.icdi.wvu.edu/teleconf/Register and click the submit 
   button once to register. 

2. Mail or Fax. You may fill out, print, and mail or FAX this form  to the Registration Coordinator.

* indicates required information.


Please place a check by each conference you wish to register for:

Format	*Register	Date		Time		Title


 Web	  FULL		2/12/2008	2:00pm EST	"Current Events" in Job Accommodation
 Web	  [   ]		3/11/2008	2:00pm EST	Chemical Sensitivities in the Workplace
 Web	  [   ]		4/8/2008	2:00pm EST	US BLN Best Practices: Part One
 Web	  FULL		5/6/2008	2:00pm EST	Accommodating Employees with Psychiatric Impairments
 Web	  [   ]		6/10/2008	2:00pm EST	US BLN Best Practices: Part Two
 Web	  FULL		7/8/2008	2:00pm EST	ADA Update with EEOC and JAN
 Web	  [   ]		8/12/2008	2:00pm EST	Accommodation Process
	


             
*Contact Name:	______________________________________________________
		First		Middle		Last   


Title:		______________________________________________________


Organization:	______________________________________________________  


*Street:	______________________________________________________


Street Line 2:	______________________________________________________


*City:		______________________________________________________


*State:		______________________________________________________


*ZIP Code:	______________________


Phone:		______________________________________________________


FAX:		______________________________________________________


*E-Mail:	______________________________________________________
                 
                  

Is Captioning Required?   Circle one:

			Yes      No  



            Please send your registration to the Registration Coordinator.