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Project for New Mexico Children and Youth Who Are Deafblind
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Registration Form

Assessments and Interventions; Case Studies in Deaf-blindness

Date:

Phone:

Name:

Address:

City:

State:

Email:

 

Are you a (Please check):
Parent (of a child with deaf-blindness?)
Yes No

Teacher/Service Provider (of a child w/deaf-blindness?) Yes No

Other (Please describe)

Employer:

Occupation:

Course Fee: $100 (Waved for New Mexico Residents)
Payable to:
Project for NM Children & Youth who are Deaf-Blind

Mail check or money order to:
UNM Center for Development & Disability
Project for NM Children & Youth Who are Deaf-blind
2300 Menaul NE
Albuquerque, NM 87107

Do you want a "Certificate of Completion" mailed to you once course is finished? Note- to receive this you must complete course. Yes No

How did you hear about this course?

Please FAX completed form to:
Project for NM Children & Youth Who Are Deaf-blind
FAX: (505) 272-5280 or email to nmdb@salud.unm.edu

For questions, email nmdb@salud.unm.edu or
call Toll Free: (877) 614-4051


For questions, call Toll Free: (877) 614-4051

Center for Development and Disability
Located at:
The Center 
for Development
and Disability

Which is a part of:
UNM School of Medicine Health Sciences Center

Supported by:
Albuquerque Public Schools Logo

U.S. Office of Special Education Programs
Funded by:
U.S. Office of 
Special Education
Programs

NM Department of Health

State of New Mexico Department of Education
Special Education

Bobby Approved

  

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UNM Center for Development and Disability, Project for New Mexico Children Who Are Deafblind.
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