Request for a Presentation/Training

Request for a Presentation or Training

Thank you for your interest about the Family Infant-Toddler Services at the Kansas State School for the Blind. Please complete the form below, and a FIT team member will follow up with you about the details of your request.
Date of Request

MonthDayYear
Name of Individual Making a Request (Contact Person)

First NameLast Name
Role/Position
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Organization/School/Agency/Local Infant-Toddler Program
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
Person Completing This Form (if different from the individual making the request)

First NameLast Name
Email
example@example.com
Topics of Interest or Event Participation

Other
Preferred Dates and Times (Please provide at least three options)
Duration

Other
Estimated number of attendees
Any accommodations or accessibility Needs
Format

Other
Location, if in-person

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Other information or Comments
We appreciate your interest in collaborating with FIT Services.

If you have any questions, please feel free to contact us at

Email: fit@kssdb.org

Telephone: (913) 645-5645
Should be Empty:

Request for a Presentation or Training