What does the participant need support in? (check all that apply)
This workshop is interactive and will require participants to engage in different ways. Please review and share if the participant will be able to do the activity independently or if they will need some support.
Please describe the types of supports/accommodations the participant will need to be successful in this workshop (enlarged text, someone to write answers, fidgets, etc.) Enter N/A if none are needed.
I understand this workshop is broken into 4 one-hour sessions and that the participant will need to attend all 4 sessions to complete the training and agree to get them to each session on time.
I agree to support the participant with coming to each session prepared (bring their workbook, completed assignments (if applicable, etc.), and ready to begin.
To help with integrating strategies learned during the workshop into their daily online activity, I understand that there will be small activities for the participant to complete at home and I agree that I will work with them to make sure they are keeping up with assignments.
I understand that because of COVID-19 and the flu and because the participants have a higher chance of being immunocompromised, social distancing practices will be in place. I agree I will check them each week prior to class to make sure they are not exhibiting any of the COVID-19 and/or flu symptoms (fever or chills, cough, shortness of breath, difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea) and have not been exposed to anyone who tested positive for COVID-19 or the flu within 14 days of their attendance.
The tuition for this workshop is $60. Thanks to a scholarship fund from the Partnership for People with Disabilities, tuition is currently reduced to $20. This includes the 4 one-hour sessions, as well as a copy of the workbook each participant will use to design their personal Online Safety Program and other resources they will use as visual reminders and prompts for online safety. To register for this workshop, a $10 deposit is needed when signing up which will be applied to the tuition. The remaining balance of $ 10 can be either paid in full at the time of registration or in one payment on the day of the first class. Please select the type of payment schedule the participant will be using.
I understand that by registering for this workshop I am agreeing that the participant will attend each section. Requests to withdraw from the workshop must be made in writing at least five (5) days before the start of the class. Requests to withdraw from workshops and classes five (5) days or more in advance will receive a refund minus the registration fee and have the choice of receiving the refund in the same method the tuition was paid or as a course credit to be applied to another workshop, class, event, or service provided by Creative Approach Development Center for up to one year from the date of the request. Requests to withdraw from the workshop made less than five (5) days before the event are not eligible for a refund (%0), but the participant may be able to enroll in another session at a later date. If the participant enrolls in the workshop less than five (5) days before it starts, they are not eligible for a refund as their enrollment date is less than the refund deadline date. There will be no refund for missed classes or deciding not to continue after the workshop has begun.
If the workshop is canceled or postponed by the Creative Approach Development Center before the start date, participants will be notified immediately and will receive a full (100%) refund in the same method they paid or if they choose as a credit for a future workshop, class, event, or service provided by Creative Approach Development Center for up to one year from the date of the request. If the workshop is canceled or postponed by the Creative Approach Development Center after the start date, the following refund schedule applies:
Please sign below to show you have read all the registration information and agree to the above statements. (Hold the right side of the mouse and move the mouse as you would to sign with a pen)
Payments can be made online using the secure Paypal payment system for Creative Approach Development Center below. If payment cannot be made online, skip the next section and hit the "submit" button to complete the registration form. Then contact Dr. Zipporah Levi-Shackleford immediately by email at ZLShackleford@CreativeApproachOnline.com or by phone at 804-554-1870 to set up a way for a check or cash payment to be made. If making a payment online, please only select ONE of the two options below. Deposit payments must be made prior to the start of class.
Please click one of the PayPal options to complete payment and submit the form.