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1. What is your relationship to Special Education?
a. Parent/ Relative of child with special needs ____
b. School Employee ____
c. Teacher – Regular Education____ Special Education____
d. Advocate ____
e. Other _________________________
2. What grade-level is of concern to you?
Preschool ____ Elementary ____ Middle school ____ High school ____ Turning 22 ____
3. Are you interested in a specific disability area?
ADD/ADHD ____ Autism/PDD ____
Intellectual Disabilities ____ Visual/Hearing Impaired ____
Developmental Disabilities ____ Physical Disabilities ____
Learning Disabilities ____ Other ____________________________
4. What workshop topics are of interest to you?
Identifying Special Needs ____ Basic Rights & the Laws ____
MCAS ____ Testing (evaluations) ____
IEPs ____ Behavior Issues ____ 504 plans ____
Financial/Insurance ____ Environmental Adaptations ____
Sensory Processing/integration ____ Communication Strategies ____
Speech & Language ____ Reading & Writing ____ Math____
Extracurricular/Summer activities ____ Homework ____
Family issues ____ Inclusion ____ Transition to Post-Secondary ______
Mediation/Hearings ____ Bullying and teasing ____ Social skills ____
Advocating Skills ____ Other___________________________________
5. Have you signed up for NAPAC E-News?
Yes_____ No____
6. Would you like to hear more about how you can get involved in NAPAC activities?
No ____ Yes_____ Name_____________________________________
Best way to reach you________________________
Thank you for your input!!
Every Child Deserves a Special Education
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