KY-SPIN's Bridging the Gap in Special Education: An in-depth training for Parents/Families

• * First Name:
• * Last Name:
• * Email Address:
• * Confirm Email Address:
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• Address 2:
• * City:
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• * ZIP Code:
• * Phone:
• * County in KY

The trainings are funded in part through a grant from Wellcare of Kentucky.

• *

  What health insurance carrier do you have? (Note: KY-SPIN will not ask for or bill your insurance, this is for WellCare's informational purposes to better assist families)

  • WellCare (please complete the next question)
  • Anthem
  • Aetna
  • Passport Molina
  • United Health
  • Humana
  • Other
  • I do not have health insurance
• To help WellCare serve the needs of their clients, please share WellCare member names and dates of birth below. (Note: KY-SPIN will not ask for or bill your insurance, this is for WellCare's informational purposes to better assist families)
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• *

  I'm registering to attend

  • September 11 & 12, 2023 at 9:30 am - 3:30 pm (ET) in Louisville, KY
  • September 19 & 20, 2023 at 9:30 am - 3:30 pm (CT) in Bowling Green, KY
  • October 10 & 11, 2023 at 9:30 am - 3:30 pm (ET) in Jackson, KY
  • October 10 & 11, 2023 at 9:30 am - 3:30 pm (ET) in Somerset, KY
  • November 4 & 5, 2023 at 9:30 am - 3:30 pm (ET) Virtually through Zoom
  • November 8 & 9, 2023 at 10am-4pm (ET) in Lexington, KY

• *

  Chose the options that best describes you: I learn best when I

  • See Graphics/Pictures
  • Hear it
  • Read it
  • Write it
  • Have examples
  • Other (Complete the next question please)
• I chose Other above, please explain how you learn best

• Ethnic Group (Optional & Confidential)

  • African American
  • Asian
  • Caucasian/White
  • Hispanic
  • Native American
  • Other

• Does your child have a disability? (Optional and Confidential)

  • Yes
  • No
  • I suspect they do
• If so, what disability? (Optional and Confidential)

• Do you have a disability? (Optional and Confidential)

  • Yes
  • No
  • I suspect I do
• If so, what disability? (Optional and Confidential)
• *

  I am a (check all that apply):

  • Person with a Disability
  • Parent/Guardian
  • Surrogate/Foster Parent
  • Grandparent
  • Sibling
  • Other Family Member
  • Other (please indicate your role below)
• * I answered "Other" above, please indicate your role in attending the training:
• * Do you need disability related accommodations to participate? If yes, please explain: Note: Reasonable accommodations will be made given ample opportunity.

• * Do you have food allergies we should be aware of?

• I would rate my understanding of the training topics before the training as (check one):

  • Expert
  • Knowledgeable
  • I know some
  • Unfamiliar