Cheetos®, Chicken Nuggets and Cheese: Assessing and Treating Eating and Feeding Issues with Toddlers and Young Children with ASD

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

Cheetos®, Chicken Nuggets and Cheese: Assessing and Treating Eating and Feeding Issues with Toddlers and Young Children with ASD

Registration Form

A two hour presentation state-wide across Iowa on April 3, 2008 from 1 - 3 p.m.

Deadline for registering to assure seating and certificates:

March 26, 2008

* 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. If you don't indicate a desire for a certificate at this time, we won't be able to accommodate requests later.
*Daytime Phone

Select a Location

IMPORTANT NOTE: Registrants will need to bring their own handout to the events. You may download the handouts at http://www.medicine.uiowa.edu/autismservices/eatingissueshandouts.htm.
I am unable to attend; please send me the lending library copy of Cheetos®, Chicken Nuggets and Cheese: Assessing and Treating Eating and Feeding Issues with 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 26, 2008.