Please complete the form on this page for the individual(s) who are attending the conference. 

First Name *

Last Name *

Email *

Email (Confirmation) *

Profession/Role *
- Select Option Community Partner Parent or Family Member Student School - Special Education Teacher School - General Education Teacher School - Paraeducator School - Administrator School - Psychologist School - Social Worker School - Consultant School - Speech and Language Provider School - OT/PT School - Other Self-Advocate State Agency or State Funded Initiative University Faculty or Staff Not listed Please specify a value for Profession/Role

School District *

Organization Name *

Do you live and/or work in Michigan? *
- Select Option Yes No

Registration Type *
- Select Option In-person; Standard ($135.00) In-person; Student (Individual should be a full-time student) ($30.00) In-person; Parent or family member of a child with a disability ($75.00)

Faculty Contact Name *

Faculty Contact Email *

Have you attended the START Conference before? *
- Select Option Yes No

Please list any specific accommodation(s) you need to fully participate in the conference. We will make every effort to accommodate each guest.

Lunch Selection

Dietary Restriction meal is Gluten and Dairy Free, Vegan, and Vegetarian friendly.

Select your prefered lunch option. *
- Select Option Chicken Dietary Restriction

Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.
Alum (garlic, onions, leeks...)
Gluten-Free
Lactose-Free
Peanut or Tree Nut
Vegan
Vegetarian
Not listed Please specify a value for Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.

First Name *

Last Name *

Email *

Email (Confirmation) *

Profession/Role *
- Select Option Community Partner Parent or Family Member Student School - Special Education Teacher School - General Education Teacher School - Paraeducator School - Administrator School - Psychologist School - Social Worker School - Consultant School - Speech and Language Provider School - OT/PT School - Other Self-Advocate State Agency or State Funded Initiative University Faculty or Staff Not listed Please specify a value for Profession/Role

School District *

Organization Name *

Do you live and/or work in Michigan? *
- Select Option Yes No

Registration Type *
- Select Option In-person; Standard ($135.00) In-person; Student (Individual should be a full-time student) ($30.00) In-person; Parent or family member of a child with a disability ($75.00)

Faculty Contact Name *

Faculty Contact Email *

Have you attended the START Conference before? *
- Select Option Yes No

Please list any specific accommodation(s) you need to fully participate in the conference. We will make every effort to accommodate each guest.

Lunch Selection

Dietary Restriction meal is Gluten and Dairy Free, Vegan, and Vegetarian friendly.

Select your prefered lunch option. *
- Select Option Chicken Dietary Restriction

Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.
Alum (garlic, onions, leeks...)
Gluten-Free
Lactose-Free
Peanut or Tree Nut
Vegan
Vegetarian
Not listed Please specify a value for Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.

First Name *

Last Name *

Email *

Email (Confirmation) *

Profession/Role *
- Select Option Community Partner Parent or Family Member Student School - Special Education Teacher School - General Education Teacher School - Paraeducator School - Administrator School - Psychologist School - Social Worker School - Consultant School - Speech and Language Provider School - OT/PT School - Other Self-Advocate State Agency or State Funded Initiative University Faculty or Staff Not listed Please specify a value for Profession/Role

School District *

Organization Name *

Do you live and/or work in Michigan? *
- Select Option Yes No

Registration Type *
- Select Option In-person; Standard ($135.00) In-person; Student (Individual should be a full-time student) ($30.00) In-person; Parent or family member of a child with a disability ($75.00)

Faculty Contact Name *

Faculty Contact Email *

Have you attended the START Conference before? *
- Select Option Yes No

Please list any specific accommodation(s) you need to fully participate in the conference. We will make every effort to accommodate each guest.

Lunch Selection

Dietary Restriction meal is Gluten and Dairy Free, Vegan, and Vegetarian friendly.

Select your prefered lunch option. *
- Select Option Chicken Dietary Restriction

Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.
Alum (garlic, onions, leeks...)
Gluten-Free
Lactose-Free
Peanut or Tree Nut
Vegan
Vegetarian
Not listed Please specify a value for Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.

First Name *

Last Name *

Email *

Email (Confirmation) *

Profession/Role *
- Select Option Community Partner Parent or Family Member Student School - Special Education Teacher School - General Education Teacher School - Paraeducator School - Administrator School - Psychologist School - Social Worker School - Consultant School - Speech and Language Provider School - OT/PT School - Other Self-Advocate State Agency or State Funded Initiative University Faculty or Staff Not listed Please specify a value for Profession/Role

School District *

Organization Name *

Do you live and/or work in Michigan? *
- Select Option Yes No

Registration Type *
- Select Option In-person; Standard ($135.00) In-person; Student (Individual should be a full-time student) ($30.00) In-person; Parent or family member of a child with a disability ($75.00)

Faculty Contact Name *

Faculty Contact Email *

Have you attended the START Conference before? *
- Select Option Yes No

Please list any specific accommodation(s) you need to fully participate in the conference. We will make every effort to accommodate each guest.

Lunch Selection

Dietary Restriction meal is Gluten and Dairy Free, Vegan, and Vegetarian friendly.

Select your prefered lunch option. *
- Select Option Chicken Dietary Restriction

Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.
Alum (garlic, onions, leeks...)
Gluten-Free
Lactose-Free
Peanut or Tree Nut
Vegan
Vegetarian
Not listed Please specify a value for Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.

First Name *

Last Name *

Email *

Email (Confirmation) *

Profession/Role *
- Select Option Community Partner Parent or Family Member Student School - Special Education Teacher School - General Education Teacher School - Paraeducator School - Administrator School - Psychologist School - Social Worker School - Consultant School - Speech and Language Provider School - OT/PT School - Other Self-Advocate State Agency or State Funded Initiative University Faculty or Staff Not listed Please specify a value for Profession/Role

School District *

Organization Name *

Do you live and/or work in Michigan? *
- Select Option Yes No

Registration Type *
- Select Option In-person; Standard ($135.00) In-person; Student (Individual should be a full-time student) ($30.00) In-person; Parent or family member of a child with a disability ($75.00)

Faculty Contact Name *

Faculty Contact Email *

Have you attended the START Conference before? *
- Select Option Yes No

Please list any specific accommodation(s) you need to fully participate in the conference. We will make every effort to accommodate each guest.

Lunch Selection

Dietary Restriction meal is Gluten and Dairy Free, Vegan, and Vegetarian friendly.

Select your prefered lunch option. *
- Select Option Chicken Dietary Restriction

Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.
Alum (garlic, onions, leeks...)
Gluten-Free
Lactose-Free
Peanut or Tree Nut
Vegan
Vegetarian
Not listed Please specify a value for Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.

First Name *

Last Name *

Email *

Email (Confirmation) *

Profession/Role *
- Select Option Community Partner Parent or Family Member Student School - Special Education Teacher School - General Education Teacher School - Paraeducator School - Administrator School - Psychologist School - Social Worker School - Consultant School - Speech and Language Provider School - OT/PT School - Other Self-Advocate State Agency or State Funded Initiative University Faculty or Staff Not listed Please specify a value for Profession/Role

School District *

Organization Name *

Do you live and/or work in Michigan? *
- Select Option Yes No

Registration Type *
- Select Option In-person; Standard ($135.00) In-person; Student (Individual should be a full-time student) ($30.00) In-person; Parent or family member of a child with a disability ($75.00)

Faculty Contact Name *

Faculty Contact Email *

Have you attended the START Conference before? *
- Select Option Yes No

Please list any specific accommodation(s) you need to fully participate in the conference. We will make every effort to accommodate each guest.

Lunch Selection

Dietary Restriction meal is Gluten and Dairy Free, Vegan, and Vegetarian friendly.

Select your prefered lunch option. *
- Select Option Chicken Dietary Restriction

Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.
Alum (garlic, onions, leeks...)
Gluten-Free
Lactose-Free
Peanut or Tree Nut
Vegan
Vegetarian
Not listed Please specify a value for Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.

First Name *

Last Name *

Email *

Email (Confirmation) *

Profession/Role *
- Select Option Community Partner Parent or Family Member Student School - Special Education Teacher School - General Education Teacher School - Paraeducator School - Administrator School - Psychologist School - Social Worker School - Consultant School - Speech and Language Provider School - OT/PT School - Other Self-Advocate State Agency or State Funded Initiative University Faculty or Staff Not listed Please specify a value for Profession/Role

School District *

Organization Name *

Do you live and/or work in Michigan? *
- Select Option Yes No

Registration Type *
- Select Option In-person; Standard ($135.00) In-person; Student (Individual should be a full-time student) ($30.00) In-person; Parent or family member of a child with a disability ($75.00)

Faculty Contact Name *

Faculty Contact Email *

Have you attended the START Conference before? *
- Select Option Yes No

Please list any specific accommodation(s) you need to fully participate in the conference. We will make every effort to accommodate each guest.

Lunch Selection

Dietary Restriction meal is Gluten and Dairy Free, Vegan, and Vegetarian friendly.

Select your prefered lunch option. *
- Select Option Chicken Dietary Restriction

Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.
Alum (garlic, onions, leeks...)
Gluten-Free
Lactose-Free
Peanut or Tree Nut
Vegan
Vegetarian
Not listed Please specify a value for Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.

First Name *

Last Name *

Email *

Email (Confirmation) *

Profession/Role *
- Select Option Community Partner Parent or Family Member Student School - Special Education Teacher School - General Education Teacher School - Paraeducator School - Administrator School - Psychologist School - Social Worker School - Consultant School - Speech and Language Provider School - OT/PT School - Other Self-Advocate State Agency or State Funded Initiative University Faculty or Staff Not listed Please specify a value for Profession/Role

School District *

Organization Name *

Do you live and/or work in Michigan? *
- Select Option Yes No

Registration Type *
- Select Option In-person; Standard ($135.00) In-person; Student (Individual should be a full-time student) ($30.00) In-person; Parent or family member of a child with a disability ($75.00)

Faculty Contact Name *

Faculty Contact Email *

Have you attended the START Conference before? *
- Select Option Yes No

Please list any specific accommodation(s) you need to fully participate in the conference. We will make every effort to accommodate each guest.

Lunch Selection

Dietary Restriction meal is Gluten and Dairy Free, Vegan, and Vegetarian friendly.

Select your prefered lunch option. *
- Select Option Chicken Dietary Restriction

Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.
Alum (garlic, onions, leeks...)
Gluten-Free
Lactose-Free
Peanut or Tree Nut
Vegan
Vegetarian
Not listed Please specify a value for Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.

First Name *

Last Name *

Email *

Email (Confirmation) *

Profession/Role *
- Select Option Community Partner Parent or Family Member Student School - Special Education Teacher School - General Education Teacher School - Paraeducator School - Administrator School - Psychologist School - Social Worker School - Consultant School - Speech and Language Provider School - OT/PT School - Other Self-Advocate State Agency or State Funded Initiative University Faculty or Staff Not listed Please specify a value for Profession/Role

School District *

Organization Name *

Do you live and/or work in Michigan? *
- Select Option Yes No

Registration Type *
- Select Option In-person; Standard ($135.00) In-person; Student (Individual should be a full-time student) ($30.00) In-person; Parent or family member of a child with a disability ($75.00)

Faculty Contact Name *

Faculty Contact Email *

Have you attended the START Conference before? *
- Select Option Yes No

Please list any specific accommodation(s) you need to fully participate in the conference. We will make every effort to accommodate each guest.

Lunch Selection

Dietary Restriction meal is Gluten and Dairy Free, Vegan, and Vegetarian friendly.

Select your prefered lunch option. *
- Select Option Chicken Dietary Restriction

Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.
Alum (garlic, onions, leeks...)
Gluten-Free
Lactose-Free
Peanut or Tree Nut
Vegan
Vegetarian
Not listed Please specify a value for Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.

First Name *

Last Name *

Email *

Email (Confirmation) *

Profession/Role *
- Select Option Community Partner Parent or Family Member Student School - Special Education Teacher School - General Education Teacher School - Paraeducator School - Administrator School - Psychologist School - Social Worker School - Consultant School - Speech and Language Provider School - OT/PT School - Other Self-Advocate State Agency or State Funded Initiative University Faculty or Staff Not listed Please specify a value for Profession/Role

School District *

Organization Name *

Do you live and/or work in Michigan? *
- Select Option Yes No

Registration Type *
- Select Option In-person; Standard ($135.00) In-person; Student (Individual should be a full-time student) ($30.00) In-person; Parent or family member of a child with a disability ($75.00)

Faculty Contact Name *

Faculty Contact Email *

Have you attended the START Conference before? *
- Select Option Yes No

Please list any specific accommodation(s) you need to fully participate in the conference. We will make every effort to accommodate each guest.

Lunch Selection

Dietary Restriction meal is Gluten and Dairy Free, Vegan, and Vegetarian friendly.

Select your prefered lunch option. *
- Select Option Chicken Dietary Restriction

Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.
Alum (garlic, onions, leeks...)
Gluten-Free
Lactose-Free
Peanut or Tree Nut
Vegan
Vegetarian
Not listed Please specify a value for Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.

First Name *

Last Name *

Email *

Email (Confirmation) *

Profession/Role *
- Select Option Community Partner Parent or Family Member Student School - Special Education Teacher School - General Education Teacher School - Paraeducator School - Administrator School - Psychologist School - Social Worker School - Consultant School - Speech and Language Provider School - OT/PT School - Other Self-Advocate State Agency or State Funded Initiative University Faculty or Staff Not listed Please specify a value for Profession/Role

School District *

Organization Name *

Do you live and/or work in Michigan? *
- Select Option Yes No

Registration Type *
- Select Option In-person; Standard ($135.00) In-person; Student (Individual should be a full-time student) ($30.00) In-person; Parent or family member of a child with a disability ($75.00)

Faculty Contact Name *

Faculty Contact Email *

Have you attended the START Conference before? *
- Select Option Yes No

Please list any specific accommodation(s) you need to fully participate in the conference. We will make every effort to accommodate each guest.

Lunch Selection

Dietary Restriction meal is Gluten and Dairy Free, Vegan, and Vegetarian friendly.

Select your prefered lunch option. *
- Select Option Chicken Dietary Restriction

Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.
Alum (garlic, onions, leeks...)
Gluten-Free
Lactose-Free
Peanut or Tree Nut
Vegan
Vegetarian
Not listed Please specify a value for Do you have any dietary restrictions? (Check all that apply) We will make every effort to accommodate each guest.