Beyond Cheetos®, Chicken Nuggets and Cheese: Practical Ideas That Work for Toddlers and Young Children with ASD

The University of Iowa
Regional Autism Services Program
Child Health Specialty Clinic

Beyond Cheetos®, Chicken Nuggets and Cheese: Practical Ideas That Work for Toddlers and Young Children with ASD

Registration Form

A one hour presentation state-wide across Iowa on March 9, 2009 from 2 - 3 p.m.

Deadline for registering to assure seating and certificates:

March 2, 2009

* Denotes required field for successful submission.

*First Name
*Last Name
*E-mail Address
*Re-enter E-mail Address
	You will receive a confirmation of your registration at the e-mail address you supply above.
*Agency
*Position
*Address

*City in Iowa
*Zip Code
*Attendance Certificate
	NOTE: If you want to request a certificate, please click on the arrow to show the drop down list.
*Daytime Phone
Select a Location
Please answer the following questions: 1. Did you attend Cheetos®, Chicken Nuggets and Cheese: Assessing and Treating Eating and Feeding Issues in Toddlers and Young Children With ASD, ICN training in April 2008?
2. If yes, Do you routinely use the Decision Tree model discussed in April 2008 when evaluating and treating children with ASD and feeding concerns?
3. Which strategies do you most commonly use when designing treatment plans to increase the variety of foods for kids with ASD? (choose 3 most used by holding down the "control" key)
IMPORTANT NOTE: Registrants will need to bring their own handouts to the events. You may download the handouts at http://www.medicine.uiowa.edu/autismservices/beyondcheetoshandouts.htm.
I am unable to attend; please send me the lending library copy of Beyond Cheetos®, Chicken Nuggets and Cheese: Practical Ideas that Work for Toddlers and Young Children with ASD. I will return it UPS.

To locate the specific address of the ICN classroom site, go to http://www3.iptv.org/iowa_database/ and click on "find a classroom".

We will be contacting someone from each site to act as host to respond to roll call and distribute materials.

If you don't see an ICN site of preference, we have already reached the seating capacity limit for that site. If you would like to be placed on a waiting list for a site, please contact Sue Baker at 319-356-4619 or sue-baker@uiowa.edu.

If something comes up after registration, please be courteous in letting us know if you are unable to attend, so we can utilize our waiting list.

We will cancel sites where no one has registered by March 2, 2009.